EPITHELIAL-STROMAL INTERACTIONS IN HUMAN KERATOTOMY WOUND-HEALING

Objective: To evaluate epithelial-stromal interactions in the healing of stromal wounds and the relationship of such interactions to regiona l variations in healing throughout keratotomy wounds. Methods: Ten rad ial keratotomy autopsy specimens were studied by using light and trans mission electron microscopy. Results: Underneath epithelial plugs, the epithelial-stromal interface was characterized by three adjacent morp hological zones: a duplicated basement membrane complex, a zone that r esembled Bowman's layer, and a third zone with collagenous fiber orien tation parallel to the plugs. Scar tissue orientation was transverse a t the base of the plug, and sagittal in deeper wound regions. Conclusi ons: Basement membrane duplication and a Bowman's layer-like region un derneath a plug may result from complicated epithelial-stromal interac tion. Asymmetrical organization of the scar, with subepithelial transv erse and sagittal deeper scar tissue orientation, may characterize rad ial keratotomy wound healing, and may relate to variations in final. r efractive effect.