Department of Ophthalmology, Rigshospitalet/Glostrup, University of Copenhagen, Copenhagen, Denmark.
Copenhagen Eye Foundation, Copenhagen, Denmark.
Sci Rep. 2018 Jan 11;8(1):492. doi: 10.1038/s41598-017-18991-7.
We set out to determine microscopic characteristics of the Descemet membrane interface during Descemet membrane endothelial keratoplasty (DMEK) graft preparation. Ten corneas were partially prepared, preserving half of the Descemet membrane attached to the stroma to enable visualisation of the Descemet-stroma interface. This tissue was prepared for viewing with a scanning electron microscope. The Descemet-stroma interface was categorised into three regions: centre, mid-periphery and periphery. We classified adhesions in these regions as either minor thread-like adhesions or major bridge-like adhesions with stromal detachments. We found a region-specific differentiation of the Descemet-stroma morphology. The presence of minor (P = 0,0001) and major (P = 0,0001) adhesions at the explored regions of the Descemet-stroma interface were found to be statistically significant. Fibrotic linear adhesions were predominant in the centre and mid-periphery, whereas the larger bridge-like adhesions were found mainly in the periphery. In addition, we observed a positive correlation between the size of the adhesions and the presence of ruptures in the underlying stromal bed. Viewing of the Descemet-stroma interface with electron microscopy reveals morphological differences between the centre of a graft and its periphery. These findings are of potential clinical relevance in terms of developing a better understanding of tissue behaviour during graft preparation.
我们旨在确定在 Descemet 膜内皮角膜移植术（DMEK）供体准备过程中 Descemet 膜界面的微观特征。10 只角膜被部分准备，保留一半与基质相连的 Descemet 膜，以便观察 Descemet-基质界面。该组织准备用扫描电子显微镜观察。将 Descemet-基质界面分为三个区域：中心、中周和外周。我们将这些区域的粘连分为轻微线状粘连或伴有基质分离的主要桥状粘连。我们发现 Descemet-基质形态存在特定区域的分化。在探索的 Descemet-基质界面区域存在轻微（P=0.0001）和主要（P=0.0001）粘连的情况具有统计学意义。纤维性线性粘连主要存在于中心和中周，而较大的桥状粘连主要存在于外周。此外，我们观察到粘连的大小与下方基质床破裂的存在之间存在正相关。用电子显微镜观察 Descemet-基质界面可以揭示移植物中心与其周围之间的形态差异。这些发现对于在移植物准备过程中更好地了解组织行为具有潜在的临床意义。
