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Chapter 2 – Abnormalities of corneal wound healing

Audrey M Bernstein

Overview

The human cornea consists of an outer stratified epithelium, and an inner monolayer of epithelial cells referred to as the corneal endothelium. The middle layer, or stroma, constitutes 90% of the thickness of the cornea and is primarily a structural matrix of collagen fibrils embedded with transparent cells (keratocytes). The structural integrity of the stroma is essential for maintaining corneal shape, strength, and transparency. All of these features are attributed to the precise alignment and spacing of the stromal collagen fibrils and associated proteoglycans, which provide a clear, undistorted optical path for vision. If the cornea is damaged by trauma, surgery, or disease, a wound-healing response rapidly begins in order to prevent infection and restore vision. In other tissues it is sufficient for wounds to heal with replacement connective tissue, in which the collagen structural organization appears to be …