The composition of wide-spaced collagen in normal and diseased Descemet's membrane.

Descemet's membrane, the specialised basement membrane of the corneal endothelium, contains a form of extracellular matrix described as wide-spaced collagen. In healthy human Descemet's membrane, wide-spaced collagen forms a highly ordered array in a region called the anterior banded zone. However, in corneal endotheliopathies such as Fuchs' endothelial dystrophy and the iridocorneal-endothelial syndrome large amounts of wide-spaced collagen are deposited posterior to Descemet's membrane in a grotesque parody of the anterior banded zone termed a posterior collagenous layer. The purpose of this study was to identify the composition of the wide-spaced collagen found in the Descemet's membrane of normal and diseased human corneas. Tissue from three normal human corneas, three from patients with Fuchs' endothelial dystrophy and five from patients with the iridocorneal-endothelial syndrome was prepared for immuno-electron microscopy by freezing or embedding in Lowicryl K4M resin. Immunocytochemistry on ultrathin sections was performed with antibodies to collagen Types I, III, V, VI and VIII, fibronectin, laminin, P component and tenascin. Ultrastructural labelling of the wide-spaced collagen in the anterior banded zone of normal and diseased corneas and also of the wide-spaced collagen in the posterior collagenous layer of all the diseased corneas was demonstrated with antibody to collagen Type VIII. Wide-spaced collagen was not labelled by any of the other antibodies used. Large amounts of Type VIII collagen are present in discrete regions of healthy and diseased Descemet's membrane. The deposition of Type VIII collagen may significantly influence the pathobiology of the corneal endotheliopathies.