Dua's Layer Isolation for Stronger Corneal Graft Handling
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Solution Overview
Problem
Existing ophthalmic surgical techniques face challenges in using the Dua's layer as a graft due to its difficult isolation and extraction, leading to structural integrity issues and increased complexity, particularly in procedures like endothelial keratoplasty.
Innovation Solution
Methods for isolating the Dua's layer using techniques such as hydrodissection, femtosecond laser dissection, and manual peeling, allowing for its preservation and subsequent use in surgical procedures, including transplantation as an onlay or inlay to treat conditions like keratoconus.
Engineering Contradictions & Design Principles
Engineering Contradiction Analysis
1Strength
If the Dua's layer is used as a tissue graft, then mechanical strength and structural integrity are improved, but the difficulty of isolation and extraction increases
Solution Approach 1:
The cornea is divided into distinct layers (epithelium, stroma, Descemet's membrane, and Dua's layer) allowing selective isolation and transplantation of the Dua's layer separately from other corneal components
Solution Approach 2:
The Dua's layer is extracted from the donor cornea using hydrodissection techniques where fluid is injected to create a blister that separates the Dua's layer from the underlying stroma, enabling its isolation for transplantation
2Reliability
If Descemet's membrane is used with endothelial cells, then tissue functionality is improved, but mechanical fragility and surgical complexity increase
Solution Approach 1:
The endothelial cells are removed from the Descemet's membrane through decellularization processes, leaving behind the acellular Dua's layer which maintains structural integrity without the fragility associated with attached endothelial cells
Solution Approach 2:
The Dua's layer serves as an intermediary substrate that can support re-endothelialization after transplantation, providing a stable foundation that is less fragile than Descemet's membrane with attached endothelial cells
Applied Scientific Principles
This section explains which scientific principles are used to turn an abstract innovation direction into a practical engineering solution.
Function Achieved in This Case
The Dua's layer provides superior mechanical characteristics, enabling safer and more effective surgical procedures with reduced risk of damage, improved graft integrity, and enhanced tissue strength, promoting cell proliferation and healing.
Implementation Method 1
The Descemet's membrane is separated from a cornea by inserting a needle into a sclera portion of the cornea, wherein the needle is coupled to a syringe filled with a fluid, and injecting the fluid from the syringe through the needle into a stroma portion of the cornea to create a blister
Implementation Method 2
The Dua's layer is separated from the cornea using a technique selected from injection of fluid underneath the Dua's layer, or using a femtosecond laser to dissect the Dua's layer
Implementation Method 3
using physical peeling, hydrodissection, air dissection, or femtosecond laser dissection to remove a Descemet's membrane from a cornea and/or to dissect the Dua's layer
Data Source
AI summary
One method of isolating the Dua's layer includes separating the Descemet's membrane from the cornea using a hydrodissection technique, removing the Descemet's membrane from the cornea, and separating the Dua's layer from the cornea. A second method of isolating the Dua's layer includes simultaneously separating the Dua's layer from the stroma and separating the Dua's layer from the Descemet's membrane. A third method of isolating the Dua's layer includes dissecting the Dua's layer from the cornea using femtosecond laser. A fourth method of isolating the Dua's layer manually dissecting the Dua's layer from the cornea using forceps. The isolated Dua's layer can be preserved as either a fresh graft for up to 14 days or as a sterile graft for up to two years. Methods of using an isolated Dua's layer include on the ocular surface, mid-stroma, on the posterior cornea, and seeded with endothelial cells for corneal application.