Dua's layer
Dua's layer is a layer of the human cornea.[1] It measures just 15 microns thick and is located between the corneal stroma and Descemet’s membrane. Despite its thinness, the layer is very strong and impervious to air.[1] It is strong enough to withstand two bars of pressure.[2]
Discovery
Dua's layer was discovered in 2013 by a team from The University of Nottingham.[2] The team was conducting transplant-related research on donated eyes. Simulating corneal surgery, they injected tiny bubbles of air into the cornea. Descemet’s membrane was surgically removed, causing the air bubble to dissipate in some specimens ("type II bubbles"), but not others ("type I bubbles"). Further experimentation revealed that all air-bubble-free specimens could be re-inflated with a type I bubble. After the bubble was inflated to the point of popping, no further bubble could be formed from further injection indicating the bubble was being trapped by a distinct layer of material, not a random variation in the corneal stroma.[1]
The experimental results were confirmed via electron microscopy. The microscope showed a thin layer of corneal collagen between the corneal stroma and Descemet’s membrane.[1] The previously unknown layer was named for team leader, professor Harminder Dua, who said the discovery means "ophthalmology textbooks will literally need to be re-written."[2] The find was first described in Ophthalmology in June 2013.[1]
Implications of discovery
Dua’s layer may help surgeons improve outcomes for patients undergoing corneal grafts and transplants. During surgery, tiny air bubbles are injected into the corneal stroma in what is known as the "big bubble technique". Sometimes the bubble bursts, causing damage to the patient's eye.[1] If the air bubble is injected under Dua’s layer instead of above it, the layer's strength reduces the risk of tearing.[1][3]
The understanding of a number of diseases of the cornea, including acute hydrops, Descematocele and pre-Descemet’s dystrophies may be affected by the discovery of Dua's layer. "From a clinical perspective, there are many diseases that affect the back of the cornea which clinicians across the world are already beginning to relate to the presence, absence or tear in this layer," Dua explains.[2]
Corneal hydrops, a buildup of fluid in the cornea that is common in patients with keratoconus (a conical deformity of the cornea) might be caused by a tear in Dua's layer.[2] Dua hypothesizes that such a tear would allow water from inside the eye to rush in and cause waterlogging.[3]
References
- ^ a b c d e f g Attention: This template ({{cite doi}}) is deprecated. To cite the publication identified by doi:10.1016/j.ophtha.2013.01.018, please use {{cite journal}} (if it was published in a bona fide academic journal, otherwise {{cite report}} with
|doi=10.1016/j.ophtha.2013.01.018instead. - ^ a b c d e Kristin Butler (June 12, 2013). "Scientists discover new layer of human cornea". UPI. Retrieved June 12, 2013.
- ^ a b "Scientists Discover New Layer of the Human Cornea". Science Daily. June 12, 2013. Retrieved June 12, 2013.
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