Epithelial-stromal interactions in human keratotomy wound healing
G. R. Melles, P. S. Binder, M. N. Moore and J. A. Anderson
Department of Ophthalmology, University of Nijmegen, The Netherlands.
OBJECTIVE: To evaluate epithelial-stromal interactions in the healing of
stromal wounds and the relationship of such interactions to regional
variations in healing throughout keratotomy wounds. METHODS: Ten radial
keratotomy autopsy specimens were studied by using light and transmission
electron microscopy. RESULTS: Underneath epithelial plugs, the
epithelial-stromal interface was characterized by three adjacent
morphological zones: a duplicated basement membrane complex, a zone that
resembled Bowman's layer, and a third zone with collagenous fiber
orientation parallel to the plugs. Scar tissue orientation was transverse
at the base of the plug, and sagittal in deeper wound regions. CONCLUSIONS:
Basement membrane duplication and a Bowman's layer-like region underneath a
plug may result from complicated epithelial-stromal interaction.
Asymmetrical organization of the scar, with subepithelial transverse and
sagittal deeper scar tissue orientation, may characterize radial keratotomy
wound healing, and may relate to variations in final refractive effect.
