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Chapter 11 – Ocular surface restoration

Julie T Daniels,
Genevieve A Secker,
Alex J Shortt

Clinical background

The ocular surface comprises the entire and continuous mucosal outer epithelial lining of the eye lids, conjunctiva, and cornea. This chapter will focus upon ocular surface failure caused by insult to the corneal epithelium and discuss current therapeutic strategies and the underlying pathophysiology.

The cornea on the front surface of the eye is comprised of five layers: the outermost multilayered epithelium, Bowman's layer (which is acellular), the keratocyte (corneal fibroblast)-populated collagen stroma, and Descemet's membrane on the inner corneal surface, upon which lies a monolayer of endothelial cells (Figure 11.1). Transparency of the cornea, and therefore vision, is dependent upon the coordinated functionality of all layers.

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Integrity of the epithelium is essential for corneal clarity and light refraction. Corneal epithelial cells are constantly lost from the ocular surface during …