Journal article
Descemet membrane adhesion strength is greater in diabetics with advanced disease compared to healthy donor corneas
Experimental Eye Research, Vol.153, pp.152-158
12/2016
DOI: 10.1016/j.exer.2016.10.015
PMID: 27777123
Abstract
Descemet membrane endothelial keratoplasty (DMEK) is an increasingly popular surgical procedure for treating ocular diseases that require a corneal transplant. Previous studies have found that tissue tearing during surgical preparation is more likely elevated in eyes from donors with a history of diabetes mellitus. To quantify these potential differences, we established an experimental technique for quantifying the force required to separate the endothelium-Descemet membrane complex (EDM) from stroma in human donor corneal tissue, and we assessed differences in adhesion strength between diabetic and non-diabetic donor corneas. Transplant suitable corneas were obtained from 23 donors 50–75 years old with an average preservation to assay time of 11.5 days. Corneas were classified from a medical records review as non-diabetic (ND, n = 9), diabetic without evidence of advanced disease (NAD, n = 8), or diabetic with evidence of advanced disease (AD, n = 10). Corneas were sectioned into 3 mm wide strips and the EDM peeled from the stroma. Using the force-extension data obtained from mechanical peel testing, EDM elastic peel tension (TE), elastic stiffness (SE), average delamination tension (TD), and maximum tension (TMAX) were calculated. Mean TE, SE, TD, and TMAX values for ND corneas were 0.78 ± 0.07 mN/mm, 0.37 ± 0.05 mN/mm/mm, 0.78 ± 0.08 mN/mm, and 0.94 ± 0.17 mN/mm, respectively. NAD values did not differ significantly. However, AD values for TE (1.01 ± 0.18 mN/mm), TD (1.09 ± 0.21 mN/mm), and TMAX (1.37 ± 0.24 mN/mm) were greater than ND and NAD corneas (P < 0.05). SE did not differ significantly between groups. These findings provide proof of the concept that chronic hyperglycemia from diabetes mellitus results in a phenotypically more adhesive interface between Descemet membrane and the posterior stroma in donor corneal tissue. Results of this study provide a foundation for further investigations into the impact of diabetes on the posterior cornea, eye banking, and keratoplasty. [Display omitted] •A method to quantify the adhesion strength of Descemet membrane to the underlying stroma is proposed.•Adhesion metrics are compared between non-diabetics and diabetics.•Increased adhesion in chronic hyperglycemia due to diabetic mellitus is indicative of diabetic donor DMEK preparation failures.
Details
- Title: Subtitle
- Descemet membrane adhesion strength is greater in diabetics with advanced disease compared to healthy donor corneas
- Creators
- Chaid Schwarz - Department of Biomedical Engineering, University of Iowa, Iowa City, IA, USABenjamin T Aldrich - Department of Ophthalmology and Visual Sciences, University of Iowa Carver College of Medicine, Iowa City, IA, USAKimberlee A Burckart - Iowa Lions Eye Bank, Coralville, IA, USAGregory A Schmidt - Iowa Lions Eye Bank, Coralville, IA, USAM. Bridget Zimmerman - College of Public Health, Department of Biostatistics, University of Iowa, Iowa City, IA, USACynthia R Reed - Iowa Lions Eye Bank, Coralville, IA, USAMark A Greiner - Department of Ophthalmology and Visual Sciences, University of Iowa Carver College of Medicine, Iowa City, IA, USAEdward A Sander - Department of Biomedical Engineering, University of Iowa, Iowa City, IA, USA
- Resource Type
- Journal article
- Publication Details
- Experimental Eye Research, Vol.153, pp.152-158
- DOI
- 10.1016/j.exer.2016.10.015
- PMID
- 27777123
- NLM abbreviation
- Exp Eye Res
- ISSN
- 0014-4835
- eISSN
- 1096-0007
- Publisher
- Elsevier Ltd
- Grant note
- name: Beulah and Florence Usher Chair; DOI: 10.13039/100001818, name: Research to Prevent Blindness; name: Cornea Excellence Fund; DOI: 10.13039/100005800, name: Eye Bank Association of America; DOI: 10.13039/100001024, name: Carver Charitable Trust, award: 13-4207
- Language
- English
- Date published
- 12/2016
- Academic Unit
- Roy J. Carver Department of Biomedical Engineering; Biostatistics; Orthopedics and Rehabilitation; Craniofacial Anomalies Research Center; Chemical and Biochemical Engineering; Ophthalmology and Visual Sciences
- Record Identifier
- 9983980061702771
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