[Technique for separating Descemet membrane for corneal endothelial cells transplantation: experimental study in...

To evaluate the percentage of endothelial cell damage induced during a surgical technique of Descemet's membrane separation containing healthy endothelium, analyze the viability and efficacy of this technique, and evaluate the percentage of endothelial cell damage caused by inversion of the cornea on an artificial anterior chamber.

The corneas from three groups of 12 New Zealand rabbits were evaluated. The Group one was used as the control, so the corneas were analyzed after collected and trephinated. The Group two was analyzed after inversion of the cornea (endothelial side up at a convex shape) mounted on an artificial anterior chamber to calculate the percentage of endothelial cell damage caused by this inversion. The Group three was evaluated after the separation between the Descemet's membrane and the stroma using viscoelastic substance in corneas inverted and mounted on an artificial anterior chamber. The endothelial cell damage was analyzed by digital photographs taken under a microscope after staining the endothelium with alizarin red. Group three samples were processed for histologic evaluation.

The Group three (viscoelastic separation) showed an index of endothelial cell damage of 10.06%, the Group two showed an index of 3.58% and the control group an index of 0.18% of endothelial cell damage (p<0.05). Histological evaluation of the Group three corneas revealed that approximately a 120 microm thickness of stroma remained attached to the Descemet's membrane.

This technique should be better investigated because it is a viable and efficient alternative of Descemet's membrane separation for endothelial cells transplantation, since the percentage of induced cell damage is 10.06%. The percentage of endothelial cell damage caused by inversion of the cornea on an artificial anterior chamber was 3.58%.