Differential Distribution of Subchains of the Basement Membrane Components Type IV Collagen and Laminin Among the Amniotic Membrane, Cornea, and Conjunctiva

Ken Fukuda, Tai-ichiro Chikama, Masatsugu Nakamura, Teruo Nishida

Cornea · 1999 · 289 citations · 0 references

Concepts

Abstract

PURPOSE: To describe a surgical technique to visualize the depth of corneal incisions and lamellar stromal dissections during surgery. METHODS: In porcine cadaver eyes, the aqueous was exchanged by air. Thus an air-to-endothelium interface (i.e., a useful optical surface) was created at the posterior corneal surface. The air-to-endothelium interface was used as a reference plane to visualize the corneal thickness and the relative depth of corneal incisions and dissections. Freehand peripheral corneal incisions, tangential keratotomy incisions, and lamellar stromal dissections were made at an intended corneal depth of 60, 80, and 99%. Light microscopy was used to measure the relative depth of the incisions and dissections. RESULTS: Achieved depth for peripheral corneal incisions averaged 65.2+/-5.3%, 78.8+/-5.1%, and 93.4+/-6.0%, respectively (p<0.05); and for tangential keratotomy incisions, 68.2+/-7.3%, 83.2+/-4.4%, and 95.8+/-3.6%, respectively (p<0.05). Achieved depth for lamellar stromal dissections averaged 58.3+/-9.4%, 81.1+/-3.4%, and 94.4+/-1.5%, respectively (p<0.05). Microperforations occurred with three incisions made at 99% intended depth. CONCLUSION: During surgery, the depth of incisions and lamellar dissections relative to the corneal thickness can be visualized by filling the anterior chamber with air (i.e., by creating an optical interface at the posterior corneal surface).