title: Scrolling Characteristics of Pre-Descemet Endothelial Keratoplasty Tissue: An Ex Vivo Study.
abstract: To evaluate the scrolling propensity of pre-Descemet endothelial keratoplasty (PDEK) tissue and to compare it with each component of the PDEK tissue, namely the pre-Descemet layer (Dua's layer [PDL]) and the Descemet membrane (DM).
  
  
  
  Experimental laboratory investigation.
  
  
  
  Fourteen human donor sclerocorneal discs in which a type 1 big bubble was obtained by stromal injection of air were studied. The wall of the type 1 big bubble was excised and its grade of scrolling noted. The components of the wall (ie, the DM and PDL) were then separated and the scrolling of each was individually graded. Statistical comparison of the grade of scrolling of each layer and correlation with age was carried out; 25-μm slices of anterior and posterior stroma obtained with the femtosecond laser from 4 control samples were used for comparison. The main outcome measure was the grade of scrolling of PDEK tissue in comparison with PDL and DM.
  
  
  
  Mean donor age was 67 years. The mean grade of the scroll formed by PDEK tissue was1.6 compared to 0.64 for PDL alone and 3.6 for DM alone. The difference was statistically significant. No correlation between donor age and degree of scrolling for any of the tissues tested was found.
  
  
  
  PDEK tissue scrolls less than DM. PDL scrolls the least. This demonstrates that PDL tissue splints the DM and reduces its scrolling in PDEK. This feature has relevance to tissue preparation, handling, and unscrolling in the eye during endothelial keratoplasty.
authors.affiliation: Academic Section of Ophthalmology, Larry A Donoso Laboratory for Eye Research, Division of Clinical Neuroscience, University of Nottingham, Nottingham, United Kingdom. Electronic address: Harminder.dua@nottingham.ac.uk.
authors.forename: Harminder S
authors.initials: HS
authors.lastname: Dua
authors.affiliation: Department of Ophthalmology and Visual Sciences, University of British Columbia, Vancouver, Canada.
authors.forename: Karolien
authors.initials: K
authors.lastname: Termote
authors.affiliation: Academic Section of Ophthalmology, Larry A Donoso Laboratory for Eye Research, Division of Clinical Neuroscience, University of Nottingham, Nottingham, United Kingdom.
authors.forename: Mohamed B
authors.initials: MB
authors.lastname: Kenawy
authors.affiliation: Academic Section of Ophthalmology, Larry A Donoso Laboratory for Eye Research, Division of Clinical Neuroscience, University of Nottingham, Nottingham, United Kingdom.
authors.forename: Dalia G
authors.initials: DG
authors.lastname: Said
authors.affiliation: LaserVision, Nuffield Health Hospital, Guildford, United Kingdom.
authors.forename: Rakesh
authors.initials: R
authors.lastname: Jayaswal
authors.affiliation: Department of Ophthalmology, National Eye Technology Centre, University of Chieti-Pescara, Chieti, Italy.
authors.forename: Mario
authors.initials: M
authors.lastname: Nubile
authors.affiliation: Department of Ophthalmology, National Eye Technology Centre, University of Chieti-Pescara, Chieti, Italy.
authors.forename: Leonardo
authors.initials: L
authors.lastname: Mastropasqua
authors.affiliation: Department of Ophthalmology and Visual Sciences, University of British Columbia, Vancouver, Canada.
authors.forename: Simon
authors.initials: S
authors.lastname: Holland
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001485:Basement Membrane / Q000502:physiology*; D003319:Corneal Stroma / Q000502:physiology; D003886:Descemet Membrane / Q000502:physiology*; D057111:Descemet Stripping Endothelial Keratoplasty; D004728:Endothelium, Corneal / Q000601:surgery; D005125:Eye Banks; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D014019:Tissue Donors; D020858:Tissue and Organ Harvesting