Epithelial-Stromal Interactions in Human Keratotomy Wound Healing
Gerrit R. J. Melles, MD;
Perry S. Binder, MD;
Max N. Moore;
Janet A. Anderson, PhD
Arch Ophthalmol. 1995;113(9):1124-1130.
Abstract
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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 epithelialstromal 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.
Author Affiliations
From the Departments of Ophthalmology and Pathology, University of Nijmegen (the Netherlands) (Dr Melles), and the Ophthalmology Research Laboratory, National Vision Research Institute, San Diego, Calif (Drs Binder and Anderson and Mr Moore).
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