University of Nottingham researchers have made a discovery that is expected to improve the success of corneal transplants for patients whose sight has been affected by disease.
The research focuses on the thin Descemet’s membrane, which is known to pose certain challenges during the Descemet’s membrane transplant procedure.
Descemet’s membrane is present between the pre-Descemets layer (Dua’s layer) and the endothelial layer in the cornea. It pumps out excess fluid and maintains the corneal dehydration required for clear vision.
In some diseases such as Fuchs Dystrophy, the endothelial cells and Descemet’s membrane get damaged. This causes water logging in the cornea, resulting in clouded vision and loss of sight over time.
Such diseases are treated via corneal transplants, where the damaged cornea parts are removed and replaced with healthy tissue.
University of Nottingham Division of Clinical Neuroscience ophthalmology professor Harminder Dua said: “This work has demonstrated a clear structural uniqueness of the pre-Descemets layer and has also answered a puzzling surgical question on the reason why the Descemets membrane rolls in one direction, when peeled off the donor eye.
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“This understanding will pave the way to develop strategies to unroll it during transplantation, with minimal damage to the cells it supports.”
Findings from the research showed that the direction of the Descemet’s membrane roll is associated with the content and distribution of elastin fibres present within the membrane.
The researchers assessed if treating the membrane with an elastin-digesting enzyme had any effect on the rolling up of the tissue.
It was observed that the enzyme treatment reversed the rolling effect and led to the degradation or disappearance of elastin in the membrane.
The team expects that this weakening of the tissue’s rolling will potentially enable easier and successful implants into the cornea. This may also reduce the potential damage to the endothelial cells.