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Descemet's Membrane in Penetrating Keratoplasties of the Human Eye

Descemet's Membrane in Penetrating Keratoplasties of the Human Eye Abstract • The response of Descemet's membrane in penetrating keratoplasty wounds was studied by light microscopy in 23 human eyes. Although only parts of the grafted areas could be sectioned in each eye, 15 splittings, full-thickness flanges, or fragmentations of Descemet's membrane were found in ten specimens. Seven of these abnormalities resulted in incarceration of Descemet's membrane into the wound. Malapposition of the wound edges was a causative factor in two additional eyes. Six of these incarcerations produced a visible stromal wound defect. Exacting surgical apposition of the stromal edges of the graft and recipient cornea can therefore be expected to reduce, but not eliminate, these healing abnormalities. Great care must be taken in cutting the graft and removing the recipient tissue to avoid stripping the tough Descemet's membrane from the overlying softer stroma with dull instruments or overlapping cuts. References 1. Polack FM, Binder PS: Detachment of Descemet's membrane from grafts following wound separation: Light and scanning electron microscopic study . Ann Ophthalmol 1975;7:47-54. 2. Waring GO, Laibson PR, Rodrigues M: Clinical and pathologic alterations of Descemet's membrane: With emphasis on endothelial metaplasia . Surv Ophthalmol 1974;18:325-366. 3. Flaxel JT: Histology of cataract extractions . Arch Ophthalmol 1970;83:436-444.Crossref 4. Brown SI, Dohlman CH, Boruchoff SA: Dislocation of Descemet's membrane during keratoplasty . Am J Ophthalmol 1965;60:43-45. 5. Henderson JW, Wolter JR: Separation of Descemet's membrane in keratoplasty . Am J Ophthalmol 1968;65:375-378. 6. Kurz GH, D'Amico RA: Retained Descemet's membrane after keratoplasty for old interstitial keratitis . Am J Ophthalmol 1973;76:51-53. 7. Hales RH, Spencer WH: Unsuccessful penetrating keratoplasties: Correlation of clinical and histologic findings . Arch Ophthalmol 1963;70:805-810.Crossref 8. Kurz GH, D'Amico RA: Histopathology of corneal graft failures . Am J Ophthalmol 1968; 66:184-199. 9. Wolter JR, Willey EN: Lamellar splitting of Descemet's membrane . Am J Ophthalmol 196661:331-334. 10. Damiano RE, van Horn DL, Schultz RD: Trephination of donor corneal buttons: A scanning electron microscopic study . Ann Ophthalmol 1978;10:479-485. 11. Morrison JC, Swan KC: Full-thickness lamellar implants: A histologic study in human eyes . Ophthalmology 1982;89:715-719.Crossref 12. Hogan MH, Alvarado JA, Weddell JE: Histology of the Human Eye . Philadelphia, WB Saunders Co, 1971, pp 82-83. 13. Morrison JC, Swan KC: Bowman's layer in penetrating keratoplasties of the human eye . Arch Ophthalmol 1982;100:1835-1838.Crossref http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Archives of Ophthalmology American Medical Association

Descemet's Membrane in Penetrating Keratoplasties of the Human Eye

Morrison, John C.; Swan, Kenneth C.
Archives of Ophthalmology , Volume 101 (12) – Dec 1, 1983
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References (14)

Publisher
American Medical Association
Copyright
Copyright © 1983 American Medical Association. All Rights Reserved.
ISSN
0003-9950
eISSN
1538-3687
DOI
10.1001/archopht.1983.01040020929020
Publisher site
See Article on Publisher Site

Abstract

Abstract • The response of Descemet's membrane in penetrating keratoplasty wounds was studied by light microscopy in 23 human eyes. Although only parts of the grafted areas could be sectioned in each eye, 15 splittings, full-thickness flanges, or fragmentations of Descemet's membrane were found in ten specimens. Seven of these abnormalities resulted in incarceration of Descemet's membrane into the wound. Malapposition of the wound edges was a causative factor in two additional eyes. Six of these incarcerations produced a visible stromal wound defect. Exacting surgical apposition of the stromal edges of the graft and recipient cornea can therefore be expected to reduce, but not eliminate, these healing abnormalities. Great care must be taken in cutting the graft and removing the recipient tissue to avoid stripping the tough Descemet's membrane from the overlying softer stroma with dull instruments or overlapping cuts. References 1. Polack FM, Binder PS: Detachment of Descemet's membrane from grafts following wound separation: Light and scanning electron microscopic study . Ann Ophthalmol 1975;7:47-54. 2. Waring GO, Laibson PR, Rodrigues M: Clinical and pathologic alterations of Descemet's membrane: With emphasis on endothelial metaplasia . Surv Ophthalmol 1974;18:325-366. 3. Flaxel JT: Histology of cataract extractions . Arch Ophthalmol 1970;83:436-444.Crossref 4. Brown SI, Dohlman CH, Boruchoff SA: Dislocation of Descemet's membrane during keratoplasty . Am J Ophthalmol 1965;60:43-45. 5. Henderson JW, Wolter JR: Separation of Descemet's membrane in keratoplasty . Am J Ophthalmol 1968;65:375-378. 6. Kurz GH, D'Amico RA: Retained Descemet's membrane after keratoplasty for old interstitial keratitis . Am J Ophthalmol 1973;76:51-53. 7. Hales RH, Spencer WH: Unsuccessful penetrating keratoplasties: Correlation of clinical and histologic findings . Arch Ophthalmol 1963;70:805-810.Crossref 8. Kurz GH, D'Amico RA: Histopathology of corneal graft failures . Am J Ophthalmol 1968; 66:184-199. 9. Wolter JR, Willey EN: Lamellar splitting of Descemet's membrane . Am J Ophthalmol 196661:331-334. 10. Damiano RE, van Horn DL, Schultz RD: Trephination of donor corneal buttons: A scanning electron microscopic study . Ann Ophthalmol 1978;10:479-485. 11. Morrison JC, Swan KC: Full-thickness lamellar implants: A histologic study in human eyes . Ophthalmology 1982;89:715-719.Crossref 12. Hogan MH, Alvarado JA, Weddell JE: Histology of the Human Eye . Philadelphia, WB Saunders Co, 1971, pp 82-83. 13. Morrison JC, Swan KC: Bowman's layer in penetrating keratoplasties of the human eye . Arch Ophthalmol 1982;100:1835-1838.Crossref

Journal

Archives of Ophthalmology – American Medical Association

Published: Dec 1, 1983

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