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The hidden sixth layer! How does the discovery of the Dua layer change the landscape of corneal surgery?
When it comes to corneal transplant surgery, many people may not be familiar with the science and technological advancements behind it. However, traditional corneal surgery techniques have changed significantly since Dr. Harminder Dua discovered the sixth layer in the cornea, the Dua layer, in 2013. The prognosticated Dua layer has become an indispensable element in traditional online operations.
What is Pre-Descemet Endothelial Keratoplasty (PDEK)?
PDEK is an endothelial keratoplasty technique in which doctors remove the inner layers of the cornea, including Descemet's membrane and Dua layer, from the donor's cornea and transplant these tissues into the patient's eye. This is different from traditional whole-sphere corneal transplantation because PDEK focuses on specialized layers of the cornea.
Conventional corneal transplantation uses the entire cornea or five layers of the cornea for revision surgery, while PDEK focuses on the inner layer of tissue taken from the donor, which significantly improves the recovery ability and visual effect of the surgery.
Discovery of the Dua layer
In May 2013, the discovery of Dua layer laid the foundation for the improvement of corneal surgery technology. This layer, located between Stroma and Descemet's membrane, is approximately 10 microns thick and is essential for the transparency and visual function of the cornea. This discovery changed doctors' understanding of the structure of the cornea and sparked further research and changes in clinical practice.
Indications for surgery
PDEK surgery is suitable for patients with corneal dysfunction, such as pseudophakic edema, congenital endothelial defunction, Fuchs corneal degeneration, and post-traumatic endothelial defunction. In these cases, PDEK effectively replaces endothelial cells that have lost function and restores visual clarity.
The successful execution of PDEK depends on the age of the donor. Young donor eyes provide optimal operating conditions and cell regeneration potential, greatly improving the success rate of the surgery.
Surgical procedure
How is PDEK surgery performed? First, the doctor will obtain a cornea sheet containing the Dua layer from the donor's eyeball. These layers require careful preoperative preparation. During the operation, the doctor will give the patient local anesthesia, then use tools to carefully remove the damaged corneal tissue in the patient's eye, and then transplant the Dua layer to the tissue.
This process requires maintaining an extremely high sterility environment to ensure the success of the surgery and reduce the risk of infection.
Postoperative care and results
After surgery, patients need to follow the doctor's recommendations for regular check-ups and care, including using eye drops and avoiding excessive strenuous activities, to protect the newly transplanted tissue. According to research, this surgery results in good visual recovery and low risk of tearing and rejection. The ideal postoperative results even lead to significant improvements in the patient's visual quality.
Future Outlook
As understanding of the Dua layer increases, the potential use of PDEK expands to neonatal and pediatric donors whose eyes have strong regenerative capabilities, providing enhanced vision not possible with older donors. Comparable. With the advancement of technology and the deepening of biological research, continuous exploration and practice will further promote the development of this field.
The Dua layer and its technology really bring hope when it comes to patients with cornea-related diseases. And will there be more progress in the future?
