A method for preparing a viable corneal endothelial layer, completely denuded of overlying stroma.

A method for denuding Descemet's membrane by dissection of all overlying stroma, while preserving the corneal endothelial layer, was developed and evaluated. The technique consists in treating the stroma with trypsin and surgically removing the softened stromal layers. With an automated thickness-measuring technique, the endothelium-Descemet preparation was found to range from 23 to 42 micron in thickness. Endothelial cell morphology was normal under specular and light-transmission microscopic examinations. Under electron microscopy, the endothelial cells appeared intact, except for an increase in the number of intracellular vacuoles. Occasionally, small portions of an intercellular space were found to be mildly dilated, but the over-all integrity of the junctional complex was intact. In vitro, the viability of the preparation was comparable with that of a cornea with all layers intact. Endothelial resting membrane potentials, measured with intracellular microelectrodes, were found to be within the normal (33 +/- 2 mV) range. It is thus possible to obtain a viable endothelial layer, completely stripped of stroma.