A Surgical Cryoprobe for Targeted Transcorneal Freezing and Endothelial Cell Removal

Abstract

PURPOSE: To examine the effects of transcorneal freezing using a new cryoprobe designed for corneal endothelial surgery. METHODS: A freezing console employing nitrous oxide as a cryogen was used to cool a series of different cryoprobe tip designs made of silver for high thermal conductivity. In vitro studies were conducted on 426 porcine corneas, followed by preliminary in vivo investigations on three rabbit corneas. RESULTS: The corneal epithelium was destroyed by transcorneal freezing, as expected; however, the epithelial basement membrane remained intact. Reproducible endothelial damage was optimally achieved using a 3.4 mm diameter cryoprobe with a concave tip profile. Stromal edema was seen in the pre-Descemet's area 24 hrs postfreeze injury, but this had been resolved by 10 days postfreeze. A normal collagen fibril structure was seen 1 month postfreeze, concurrent with endothelial cell repopulation. CONCLUSIONS: Transcorneal freezing induces transient posterior stromal edema and some residual deep stromal haze but leaves the epithelial basement membrane intact, which is likely to be important for corneal re-epithelialization. Localized destruction of the endothelial monolayer was achieved in a consistent manner with a 3.4 mm diameter/concave profile cryoprobe and represents a potentially useful approach to remove dysfunctional corneal endothelial cells from corneas with endothelial dysfunction.

Publication DOI: https://doi.org/10.1155/2017/5614089
Divisions: College of Health & Life Sciences
College of Health & Life Sciences > School of Optometry > Optometry
Additional Information: Copyright © 2017 Alina Akhbanbetova et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Publication ISSN: 2090-0058
Last Modified: 19 Mar 2024 08:15
Date Deposited: 07 Oct 2019 12:42
Full Text Link:
Related URLs: https://www.hin ... h/2017/5614089/ (Publisher URL)
PURE Output Type: Article
Published Date: 2017-05-16
Accepted Date: 2017-02-13
Authors: Akhbanbetova, Alina
Nakano, Shinichiro
Littlechild, Stacy L
Young, Robert D
Zvirgzdina, Madara (ORCID Profile 0000-0002-1466-5017)
Fullwood, Nigel J
Weston, Ian
Weston, Philip
Kinoshita, Shigeru
Okumura, Naoki
Koizumi, Noriko
Quantock, Andrew J

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License: Creative Commons Attribution


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