Effect of Collagenase A on Descemet Membrane Endothelial Keratoplasty Scroll Tightness

Moolla, Luqmaan; Din, Nizar; Cohen, Eyal; Slomovic, Allan R.; Rootman, David S.; Chan, Clara C.

doi:10.1097/ico.0000000000003030

Cited by 2 publications

(2 citation statements)

References 19 publications

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“…10,11,16 Placement of an F or S mark on the anterior surface of the DM helps with orientation, but none of the procedures described reduce the grade of the scroll. Attempts at limiting, modifying or reversing the tightness and con guration (single or double) of the DM scroll have been made with enzyme treatment, 17 polymer coating, 18 or mechanical means. 14,15 Thus, the scrolling of the DM is both a friend and a foe.…”

Section: Discussionmentioning

confidence: 99%

An approach to reduce Descemet’s membrane scrolling: Relevance to Descemet’s membrane endothelial keratoplasty (DMEK)

Dua

Freitas²,

Sadek³

et al. 2023

Preprint

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Background/Objectives: To determine whether Descemet’s membrane (DM) scrolling occurs primarily along the vertical or horizontal axis and establish whether oval trephination along the axis of least scrolling can reduce the grade of the scroll. Subjects/Methods:The longest limbus-to-limbus axis on 28 sclero-corneal discs was taken as the horizontal axis. The horizontal (n=7) or (right angles to it) vertical (n=6) axis was marked on the DM before peeling it off. The direction and grade of scrolling was observed. Narrow strips (3-4mm wide) were then cut along the two axes (n=4 each) and the scrolling pattern observed. Ellipses (7x9mm) of DM were punched along the two axes (n=6 each) and the scrolls graded. Immunofluorescent staining for elastin, on horizontal and vertical tissue sections from 3 DM samples was performed. The intensity and thickness of elastin staining were measured. Results: 24 (85.72%) DM samples showed scrolling along the horizontal axis, none along the vertical axis, and 4 (14.28%) showed a spiral scroll, regardless of which axis was marked (grade 3.7 and 3.6). Vertically oval discs showed significantly reduced scrolling (grade 1.2) compared to horizontally oval discs (grade 3.5). Narrow strips of DM showed a similar scrolling pattern. Immunohistology showed no difference in any of the parameters examined, along the two axes or from center to periphery. Conclusion: DM scrolls primarily along the horizontal axis. Vertically oval DM samples show minimal scrolling, which can be an advantage in DMEK. The differential scrolling is not determined by the distribution of elastin.

show abstract

Section: Discussionmentioning

confidence: 99%

An approach to reduce Descemet’s membrane scrolling: Relevance to Descemet’s membrane endothelial keratoplasty (DMEK)

Dua

Freitas²,

Sadek³

et al. 2023

Preprint

View full text Add to dashboard Cite

show abstract

“…[ 10 11 16 ] Placement of an F or S mark on the anterior surface of DM helps with orientation, but none of the procedures described reduce the grade of the scroll. Attempts at limiting, modifying, or reversing the tightness and configuration (single or double) of the DM scroll have been made with enzyme treatment,[ 17 ] polymer coating,[ 18 ] or mechanical means. [ 14 15 ] Thus, scrolling of DM is both a friend and a foe.…”

Section: Discussionmentioning

confidence: 99%

An approach to reduce Descemet’s membrane scrolling: Relevance to Descemet’s membrane endothelial keratoplasty (DMEK)

Dua,

Freitas,

Sadek

et al. 2023

Indian Journal of Ophthalmology

View full text Add to dashboard Cite

Purpose: We aimed to determine whether Descemet’s membrane (DM) scrolling occurs primarily along the vertical or horizontal axis and establish whether oval trephination along the axis of least scrolling can reduce the grade of the scroll. Methods: The longest limbus-to-limbus axis on 28 sclerocorneal discs was taken as the horizontal axis. The horizontal (n = 7) or (right angles to it) vertical (n = 6) axis was marked on DM before peeling it off. The direction and grade of scrolling was observed. Narrow strips (3–4 mm wide) were then cut along the two axes (n = 4 each) and the scrolling pattern was observed. Ellipses (7 × 9 mm) of DM were punched along the two axes (n = 6 each) and the scrolls graded. Immunofluorescent staining for elastin on horizontal and vertical tissue sections from three DM samples was performed. The intensity and thickness of elastin staining were measured. Results: Twenty-four (85.72%) DM samples showed scrolling along the horizontal axis, none showed scrolling along the vertical axis, and four (14.28%) samples showed a spiral scroll, regardless of which axis was marked (grade 3.7 and 3.6). Vertically oval discs showed significantly reduced scrolling (grade 1.2) compared to horizontally oval discs (grade 3.5). Narrow strips of DM showed a similar scrolling pattern. Immunohistology showed no difference in any of the parameters examined along the two axes or from the center to the periphery. Conclusion: DM scrolls primarily along the horizontal axis. Vertically oval DM samples show minimal scrolling, which can be an advantage in DMEK. Differential scrolling is not determined by the distribution of elastin.

show abstract

Effect of Collagenase A on Descemet Membrane Endothelial Keratoplasty Scroll Tightness

Cited by 2 publications

References 19 publications

An approach to reduce Descemet’s membrane scrolling: Relevance to Descemet’s membrane endothelial keratoplasty (DMEK)

An approach to reduce Descemet’s membrane scrolling: Relevance to Descemet’s membrane endothelial keratoplasty (DMEK)

An approach to reduce Descemet’s membrane scrolling: Relevance to Descemet’s membrane endothelial keratoplasty (DMEK)

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