surface of the globe. This dissection was similarly continued until past the level of the fornices. The fatty tissue and Tenon’s capsule behind the conjunctiva were then divided until the anterior and posterior planes met, as demonstrated in Fig. 1I. It was found that it was easier to perform this dissection from the anterior plane using scissors to cut down onto the globe, taking care to do so beyond the fornices, so as not to breach the conjunctiva. This was completed circumferentially allowing the conjunctiva to be excised as a whole specimen. Eye sockets were reconstructed using cotton wool and plastic eye shields that hold the eyelids in a closed position in accordance with the guidance standards of the Royal College of Ophthalmologists (2008) with good aesthetic results. Using this technique, whole conjunctival tissue was successfully obtained from 16 human cadaveric donors (32 eyes). Conjunctival tissue was subsequently wax embedded, sectioned and examined histologically confirming the presence of tarsal to limbal conjunctiva (Fig. 1J). Conjunctival epithelial cells were also harvested using trypsin disaggregation and co-cultured on an inactivated J23T3 mouse fibroblast feeder layer. Cultured cells were fixed in methanol and immunofluorescently stained for the conjunctival marker cytokeratin 19 (R. M. K. Stewart unpublished data). We have developed a technique to retrieve whole human cadaveric conjunctiva. This will further enable future ex vivo and in vitro analyses of the whole human conjunctiva, which require a continuum of conjunctival tissue. This is of particular benefit to studies assessing the distribution and characterization of conjunctival stem cells to aid propagation and transplantation; similarly for inflammatory cells and vasculature to improve knowledge of ocular surface immunity and potential for therapeutic agents.
Read full abstract