VARIATION IN HEALING THROUGHOUT THE DEPTH OF LONG-TERM, UNSUTURED, CORNEAL WOUNDS HUMAN AUTOPSY SPECIMENS AND MONKEYS

Objective: To determine regional differences in stromal wound healing morphologic features in long-term radial keratotomy wounds. Methods: U nsutured, semiradial, nonperforating wounds in seven monkeys and 10 hu man autopsy specimens obtained 3.5 to 52 months after surgery were ana lyzed using light, transmission, and fluorescent microscopy. Results: Monkeys showed fast healing, whereas all human specimens had one or mo re incisions containing a superficial epithelial plug. Completely heal ed wounds in both models had fibroblast orientation and ultrastructura l ''pseudolamellar'' (ie, colinear collagen fiber) continuity across t he anterior wound, compared with disorganization of the midposterior s car. Conclusions: Regional differences in healing rates, mechanical fa ctors associated with epithelial plug elimination, intrinsic tissue ch aracteristics, and/or induction of pseudolamellar repair by the epithe lial plug may explain variation in healing within an unsutured corneal wound.