Variation in healing throughout the depth of long-term, unsutured, corneal wounds in human autopsy specimens and monkeys.
OBJECTIVE
To determine regional differences in stromal wound healing morphologic features in long-term radial keratotomy wounds.


METHODS
Unsutured, semiradial, nonperforating wounds in seven monkeys and 10 human autopsy specimens obtained 3.5 to 52 months after surgery were analyzed using light, transmission, and fluorescent microscopy.


RESULTS
Monkeys showed fast healing, whereas all human specimens had one or more incisions containing a superficial epithelial plug. Completely healed wounds in both models had fibroblast orientation and ultrastructural "pseudolamellar" (ie, colinear collagen fiber) continuity across the anterior wound, compared with disorganization of the midposterior scar.


CONCLUSIONS
Regional differences in healing rates, mechanical factors associated with epithelial plug elimination, intrinsic tissue characteristics, and/or induction of pseudolamellar repair by the epithelial plug may explain variation in healing within an unsutured corneal wound.
Melles
G R
GR
Ophthalmology Research Laboratory, Sharp Cabrillo Hospital, San Diego, Calif.
Binder
P S
PS
Anderson
J A
JA
D000328:Adult; D000818:Animals; D003094:Collagen / Q000648:ultrastructure; D003319:Corneal Stroma / Q000601:surgery / Q000648:ultrastructure*; D004848:Epithelium / Q000601:surgery / Q000648:ultrastructure; D005260:Female; D005347:Fibroblasts / Q000648:ultrastructure; D006801:Humans; D007646:Keratotomy, Radial; D008137:Longitudinal Studies; D008252:Macaca fascicularis; D008297:Male; D008875:Middle Aged; D012030:Refractive Errors / Q000503:physiopathology; D013536:Suture Techniques; D014945:Wound Healing / Q000502:physiology
D003094:Collagen