The immune system has a fundamental role in the development and regulation
of ocular healing, which plays an important role in the pathogenesis of mos
t blinding diseases. This review discusses the mechanisms of normal wound h
ealing, describing the animal and fetal wound healing models used to provid
e further insight into normal wound repair. In particular, conjunctival wou
nd repair after glaucoma filtration surgery will be used to illustrate the
contributions that the different components of the immune system make to th
e healing process. The potential role of macrophages, the possible regulato
ry effect of lymphocytes, and the important role of growth factors and cyto
kines in the wound healing reaction are discussed. The significance of the
immune system in the pathogenesis of aggressive conjunctival scarring is ad
dressed, particularly assessing the predisposing factors, including drugs,
age, and ethnicity. The rationale behind the pharmacological agents current
ly used to modulate the wound healing response and the effects these drugs
have on the function of the immune system are described. Finally, potential
new therapeutic approaches to regulating the wound healing response are re
ported. (Surv Ophthalmol 45:49-68, 2000. (C) 2000 by Elsevier Science Inc.
All rights reserved.).