A Surgical Cryoprobe for Targeted Transcorneal Freezing and Endothelial Cell Removal
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 vitr...
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Wiley
2017-01-01
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Series: | Journal of Ophthalmology |
Online Access: | http://dx.doi.org/10.1155/2017/5614089 |
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author | Alina Akhbanbetova Shinichiro Nakano Stacy L. Littlechild Robert D. Young Madara Zvirgzdina Nigel J. Fullwood Ian Weston Philip Weston Shigeru Kinoshita Naoki Okumura Noriko Koizumi Andrew J. Quantock |
author_facet | Alina Akhbanbetova Shinichiro Nakano Stacy L. Littlechild Robert D. Young Madara Zvirgzdina Nigel J. Fullwood Ian Weston Philip Weston Shigeru Kinoshita Naoki Okumura Noriko Koizumi Andrew J. Quantock |
author_sort | Alina Akhbanbetova |
collection | DOAJ |
description | 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. |
format | Article |
id | doaj-art-53de991711b74fd8917909f35f9e2f92 |
institution | Kabale University |
issn | 2090-004X 2090-0058 |
language | English |
publishDate | 2017-01-01 |
publisher | Wiley |
record_format | Article |
series | Journal of Ophthalmology |
spelling | doaj-art-53de991711b74fd8917909f35f9e2f922025-02-03T01:30:36ZengWileyJournal of Ophthalmology2090-004X2090-00582017-01-01201710.1155/2017/56140895614089A Surgical Cryoprobe for Targeted Transcorneal Freezing and Endothelial Cell RemovalAlina Akhbanbetova0Shinichiro Nakano1Stacy L. Littlechild2Robert D. Young3Madara Zvirgzdina4Nigel J. Fullwood5Ian Weston6Philip Weston7Shigeru Kinoshita8Naoki Okumura9Noriko Koizumi10Andrew J. Quantock11Structural Biophysics Research Group, School of Optometry and Vision Sciences, Cardiff University, Maindy Road, Cardiff CF24 4HQ, UKDepartment of Biomedical Engineering, Faculty of Life and Medical Sciences, Doshisha University, 1-3 Miyakodami-Tatara, Kyoto 610-0321, JapanStructural Biophysics Research Group, School of Optometry and Vision Sciences, Cardiff University, Maindy Road, Cardiff CF24 4HQ, UKStructural Biophysics Research Group, School of Optometry and Vision Sciences, Cardiff University, Maindy Road, Cardiff CF24 4HQ, UKStructural Biophysics Research Group, School of Optometry and Vision Sciences, Cardiff University, Maindy Road, Cardiff CF24 4HQ, UKDivision of Biomedical and Life Sciences, Faculty of Health and Medicine, Lancaster University, Lancaster LA1 4YQ, UKNetwork Medical Products Ltd. Coronet House, Kearsley Road, Ripon, North Yorkshire HG4 2SG, UKNetwork Medical Products Ltd. Coronet House, Kearsley Road, Ripon, North Yorkshire HG4 2SG, UKDepartment of Frontier Medical Science and Technology for Ophthalmology, Kyoto Prefectural University of Medicine, Hirokoji-Kawaramachi, Kyoto 602-0841, JapanDepartment of Biomedical Engineering, Faculty of Life and Medical Sciences, Doshisha University, 1-3 Miyakodami-Tatara, Kyoto 610-0321, JapanDepartment of Biomedical Engineering, Faculty of Life and Medical Sciences, Doshisha University, 1-3 Miyakodami-Tatara, Kyoto 610-0321, JapanStructural Biophysics Research Group, School of Optometry and Vision Sciences, Cardiff University, Maindy Road, Cardiff CF24 4HQ, UKPurpose. 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.http://dx.doi.org/10.1155/2017/5614089 |
spellingShingle | Alina Akhbanbetova Shinichiro Nakano Stacy L. Littlechild Robert D. Young Madara Zvirgzdina Nigel J. Fullwood Ian Weston Philip Weston Shigeru Kinoshita Naoki Okumura Noriko Koizumi Andrew J. Quantock A Surgical Cryoprobe for Targeted Transcorneal Freezing and Endothelial Cell Removal Journal of Ophthalmology |
title | A Surgical Cryoprobe for Targeted Transcorneal Freezing and Endothelial Cell Removal |
title_full | A Surgical Cryoprobe for Targeted Transcorneal Freezing and Endothelial Cell Removal |
title_fullStr | A Surgical Cryoprobe for Targeted Transcorneal Freezing and Endothelial Cell Removal |
title_full_unstemmed | A Surgical Cryoprobe for Targeted Transcorneal Freezing and Endothelial Cell Removal |
title_short | A Surgical Cryoprobe for Targeted Transcorneal Freezing and Endothelial Cell Removal |
title_sort | surgical cryoprobe for targeted transcorneal freezing and endothelial cell removal |
url | http://dx.doi.org/10.1155/2017/5614089 |
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