Variation in Healing Throughout the Depth of Long-term, Unsutured, Corneal Wounds in Human Autopsy Specimens and Monkeys

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Abstract
Objective: To determine regional differences in stromal wound healing morphologic features in long-term radial keratotomy wounds. Methods: Unsutured, semiradial, nonperforating wounds in seven monkeys and 10 human autopsy specimens obtained 3.5 to 52 months after surgery were analyzed using light, transmission, and fluorescent microscopy. Results: Monkeys showed fast healing, whereas all human specimens had one or more incisions containing a superficial epithelial plug. Completely healed wounds in both models had fibroblast orientation and ultrastructural "pseudolamellar" (ie, colinear collagen fiber) continuity across the anterior wound, compared with disorganization of the midposterior scar. Conclusions: Regional differences in healing rates, mechanical factors associated with epithelial plug elimination, intrinsic tissue characteristics, and/or induction of pseudolamellar repair by the epithelial plug may explain variation in healing within an unsutured corneal wound.