Experimental autologous inverse keratoplasty--epithelial, stromal and endothelial interactions

After the reversal of a 4-mm central corneal button in 20 rabbits, no epithelial proliferation was observed in the anterior chamber. The epithelium and the wound margins facing the anterior chamber were covered by a large fibrin clot, which suppressed epithelial cell growth and served as a matrix for rapidly proliferating fibroblasts while apparently stimulating their growth. The inverted epithelium was overgrown by stromal tissue and eventually disappeared. Fibrous proliferation ceased after tissue had been covered by corneal endothelium. We suggest that fibrin clotting and stromal fibroblastic proliferation are important factors that prevent epithelial growth on the inner corneal surface.