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Human corneal anatomy redefined: a novel pre-Descemet's layer (Dua's layer)
Harminder S Dua1, Lana A Faraj, Dalia G Said
1Larry A Donoso Laboratory for Eye Research, Division of Ophthalmology and Visual Sciences, School of Clinical Sciences, Division of Histopathology, University of Nottingham, United Kingdom. harminder.dua@nottingham.ac.uk
Ophthalmology
|May 30, 2013
Summary
Researchers identified a new layer in the human cornea, termed Dua's layer. This acellular pre-Descemet's layer has significant implications for corneal surgery and understanding corneal diseases.
Area of Science:
- Ophthalmology
- Corneal Anatomy
- Surgical Techniques
Background:
- The existence and properties of a distinct pre-Descemet's layer in the human cornea have been debated.
- Understanding corneal layers is crucial for advancing ophthalmic surgical procedures and treating corneal pathologies.
Purpose of the Study:
- To define and characterize a novel pre-Descemet's layer in the human cornea.
- To investigate the anatomical and biomechanical properties of this newly identified layer.
Main Methods:
- A clinical and experimental study involving 31 human donor sclerocorneal discs.
- The big bubble (BB) technique was employed to create air bubbles in the corneal stroma.
- Histological examination was performed on tissues obtained from experiments involving Descemet's membrane (DM) manipulation and bubble creation.
Main Results:
- Three types of big bubbles (BB) were observed, with Type-1 BB facilitating complete Descemet's membrane peeling, indicating an additional layer.
- Histology confirmed an acellular layer, measuring 10.15 ± 3.6 microns, located posterior to the last keratocyte row.
- The popping pressure differed between Type-1 (1.45 bar) and Type-2 (0.6 bar) BBs.
Conclusions:
- A novel, well-defined, acellular layer, named Dua's layer, exists in the pre-Descemet's cornea.
- This layer separates along the last row of keratocytes during the BB technique.
- The discovery impacts posterior corneal surgery, corneal biomechanics, and understanding of conditions like acute hydrops and dystrophies.
