Corneal Epithelial Wound Healing: Cellular Mechanisms and Therapeutic Approaches
摘要
The corneal epithelium is a unique structure that protects and covers the anterior portion of the cornea. Although only approximately 50–60 μm in thickness, maintenance of corneal epithelial health is of utmost importance for corneal clarity and the visual pathway. The corneal epithelium is also one of the unique structures in the human body that is constantly being renewed by limbal epithelial stem cells. These mechanisms also play a role in corneal epithelial wound healing. In this chapter, we review the anatomy of the cornea, particularly the cornea epithelium and its sublayers. We discuss the mechanism of corneal epithelial wound healing and its phases which are characterized by the lag phase, migration phase, proliferation phase, and adhesion phase. We then discuss factors that affect corneal epithelial wound healing including genetic and molecular factors, local factors (e.g., hypoxia and inflammation), systemic factors (e.g., aging, diabetes), and environmental factors (e.g., ultraviolet light exposure). We then conclude by reviewing therapeutic interventions to optimize corneal epithelial healing including pharmacologic, nonsurgical, and surgical approaches.