Skip to main content

Thank you for visiting nature.com. You are using a browser version with limited support for CSS. To obtain the best experience, we recommend you use a more up to date browser (or turn off compatibility mode in Internet Explorer). In the meantime, to ensure continued support, we are displaying the site without styles and JavaScript.

  • Brief Communication
  • Published:

Descemet’s membrane or confirmation of a novel corneal structure: the layer of Dua

Eye volume 38, pages 1217–1218 (2024)Cite this article

Subjects

After the original description of the Predescemetic layer - Dua’s layer [1] (PDL/DL) and its practical implementation in the Predescemetic Endothelial Keratoplasty (PDEK), its clinical identification in non-operated eyes remains controversial. Our observation could offer further proof of the existence of the newly reported posterior corneal layer.

The clinical importance of the latter corneal layer above cannot fully determined. We hypothesise that this second hyperreflective layer may affect corneal biomechanics and deturgescence. In addition to indicating senescence and collagen/metabolic byproducts accumulation, this layer may also contribute in corneal resistance to fluid ingress that leads to corneal oedema. This can potentially explain why, to date, the critical number of corneal endothelial cells before corneal oedema ensues remains unknown and may vary by patient. The development of bullous keratopathy could be multifactorial involving the endothelial cells as well as the thickness and tensile strength of the cornea. If this layer corresponds to the natural position of DL, its precise significance will be further debated, as it has previously been discussed in lamellar corneal surgery.

This is a preview of subscription content, access via your institution

Access options

Buy this article

  • Purchase on Springer Link
  • Instant access to full article PDF
Buy now

Prices may be subject to local taxes which are calculated during checkout

Fig. 1
Fig. 2: OCT scan of the cornea in both eyes showing the second distinct layer present anterior to Descemet’s membrane (yellow arrow).

References

  1. Dua HS, Faraj LA, Said DG, Gray T, Lowe J. Human corneal anatomy redefined: a novel pre-Descemet’s layer (Dua’s layer). Ophthalmology. 2013;120:1778–85.

    Article  PubMed  Google Scholar 

  2. Murphy C, Alvarado J, Juster R. Prenatal and postnatal growth of the human Descemet’s membrane. Invest Ophthalmol Vis Sci. 1984;25:1402–15.

    CAS  PubMed  Google Scholar 

  3. Johnson DH, Bourne WM, Campbell RJ. The ultrastructure of Descemet’s membrane. I. Changes with age in normal corneas. Arch Ophthalmol. 1982;100:1942–7.

    Article  CAS  PubMed  Google Scholar 

  4. Kaluzny BJ, Szkulmowska A, Szkulmowski M, Bajraszewski T, Kowalczyk A, Wojtkowski M. Fuchs’ endothelial dystrophy in 830-nm spectral domain optical coherence tomography. Ophthalmic Surg Lasers Imaging. 2009;40:198–200.

    Article  PubMed  Google Scholar 

  5. Marshall J, Grindle CF. Fine structure of the cornea and its development. Trans Ophthalmol Soc UK. 1978;98:320–8. (1962).

    CAS  PubMed  Google Scholar 

  6. Dua HS, Freitas R, Mohammed I, Ting DSJ & Said DG. The pre-Descemet’s layer (Dua’s layer, also known as the Dua-Fine layer and the pre-posterior limiting lamina layer): Discovery, characterisation, clinical and surgical applications, and the controversy. Prog Retin Eye Res. 2023;97:101161.

Download references

Author information

Authors and Affiliations

  1. University Eye Department, Democritus University of Thrace, Alexandroupolis, Greece

    Yannis Athanasiadis, Panagiota Ntonti, Eirini-Kanella Panagiotopoulou & Georgios Labiris

  2. University Eye Department, Aristotle University of Thessaloniki, Thessaloniki, Greece

    Michael Tsatsos

Authors
  1. Yannis Athanasiadis
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Michael Tsatsos
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Panagiota Ntonti
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Eirini-Kanella Panagiotopoulou
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Georgios Labiris
    View author publications

    You can also search for this author in PubMed Google Scholar

Contributions

YA and MT participated in the design of the study, YA collected and EKP prepared the data. YA, MT and PN were responsible for the analysis and presentation of the results. YA, MT, PN, EKP and GL drafted the manuscript, critically evaluated the article, and gave their final approval before submission.

Corresponding author

Correspondence to Yannis Athanasiadis.

Ethics declarations

Competing interests

The authors declare no competing interests.

Additional information

Publisher’s note Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Rights and permissions

Springer Nature or its licensor (e.g. a society or other partner) holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law.

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Athanasiadis, Y., Tsatsos, M., Ntonti, P. et al. Descemet’s membrane or confirmation of a novel corneal structure: the layer of Dua. Eye 38, 1217–1218 (2024). https://doi.org/10.1038/s41433-023-02851-y

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1038/s41433-023-02851-y

This article is cited by

Search

Advanced search

Quick links