Healed Perforated Corneal Ulcers in Human.

Area of Science:

• Ophthalmology
• Cell Biology
• Tissue Engineering

Background:

• Perforated corneal ulcers (HPCUs) can lead to vision impairment due to scarring and leakage.
• Keratoplasty is often required to restore corneal function after severe HPCUs.
• Understanding the cellular mechanisms of corneal wound healing is crucial for developing regenerative strategies.

Purpose of the Study:

• To investigate the pathophysiological process of healed perforated corneal ulcers (HPCUs) in human corneal specimens.
• To elucidate the cellular and molecular events during the stages of corneal wound healing after injury.

Main Methods:

• Human corneal specimens from keratoplasty for HPCUs were analyzed.
• Transmission electron microscopy (TEM) was used to examine cellular structures and tissue layers.
• Immunofluorescence (IF) was employed to detect specific cellular markers and proteins (e.g., vimentin, αSMA, PCNA, CK14, H2AX).

Main Results:

• Early healing stages showed layered structures with polygonal and elongated cells, lacking endothelial cells and Descemet's membrane (DM).
• Intermediate stages revealed a three-layered structure with increased stromal collagen, followed by endothelial cell migration to reform DM.
• Immunofluorescence confirmed the presence of myofibroblasts, proliferating cells, and apoptotic markers, highlighting complex cellular dynamics during healing.

Conclusions:

• Corneal wound healing is a dynamic process involving apoptosis, cell migration, mitosis, differentiation, and extracellular matrix remodeling.
• The cornea reconstructs its five-layer structure through sequential cellular events, including the reformation of Descemet's membrane.
• Myofibroblasts and cell proliferation play significant roles in the repair of damaged corneal tissue.