Riks I A, Trufanov S V, Papanyan S S
Pavlov First Saint Petersburg State Medical University, Saint Petersburg, Russia.
Diagnostic Center No. 7, Saint Petersburg, Russia.
Vestn Oftalmol. 2023;139(2):113-116. doi: 10.17116/oftalma2023139021113.
The five-layer structure of the cornea has been generally accepted in anatomy for the last 70 years. Since the beginning of 2000, publications about lamellar keratoplasty have appeared, in which during the operation it was necessary to isolate the Descemet's membrane (DM). Several options for the formation of a big bubble have been described; in the most frequently used type, the presence of remnants of thin stromal tissue on the isolated DM were found. In 2013 an English group of researchers headed by H. Dua tried to prove that this thin strip of the stroma in DM is the sixth layer of the cornea. However, there is a sufficient number of publications that refute this "discovery". In Russian scientific literature there has been no discussion of a «new» layer of the cornea. Only recently one article has been published, which raised the issue of this separate layer in the cornea. Our group of authors has also entered this discourse, believing that it is possible to distinguish terminologically the pre-Descemet's layers, but only as part of the corneal stroma, without attributing it with numerous functions and features.
在过去70年里，角膜的五层结构在解剖学上已被普遍接受。自2000年初以来，出现了一些关于板层角膜移植术的出版物，其中在手术过程中需要分离后弹力层（DM）。已经描述了几种形成大气泡的方法；在最常用的类型中，在分离的后弹力层上发现了薄的基质组织残余。2013年，由H. Dua领导的一个英国研究小组试图证明后弹力层中的这条薄基质带是角膜的第六层。然而，有足够多的出版物反驳了这一“发现”。在俄罗斯科学文献中，没有关于角膜“新”层的讨论。直到最近才发表了一篇文章，提出了角膜中这一单独层的问题。我们的作者团队也参与了这一讨论，认为从术语上可以区分后弹力层前层，但只能将其作为角膜基质的一部分，而不能赋予它众多的功能和特征。
