Stromal-cellular aspects of corneal reparative regeneration in traumatic ocular globe injuries

Authors

Keywords:

eye, ocular tunics, penetrating eye injury, ocular trauma, pathology, cornea, regeneration, scar.

Abstract

Background. The cornea is a crucial component of the eye's refractive apparatus. Its unique structure ensures perfect transparency and provides its light-refracting properties. Addressing the challenges of reconstructing the eye following traumatic injuries of various origins is a pressing concern in contemporary theoretical and practical medicine. Among these injuries, penetrating traumas and damage to the ocular globe often require reconstructive surgery to maximize the restoration of affected structures, including the cornea. However, a frequent complication following postoperative reparative regeneration of the cornea is the formation of a connective tissue scar, which significantly reduces its optical properties and overall visual acuity. Objective. This study aimed to investigate the micro- and submicroscopic structural organization of corneal scars following penetrating mechanical trauma to the eye. Methods. Samples of corneas exhibiting scarring were obtained from 19 patients 12 months after the occurrence of penetrating trauma. Light microscopy was employed to examine transverse sections of the cornea, and electron microscopy was utilized for ultrastructural analysis. Quantitative analysis of corneal thickness changes in the paracscar and scar zones was conducted over time. Results and conclusion. The morphologic investigation of the corneal state following penetrating injuries revealed epithelial ingrowth and proliferation into the corneal stroma at sites of anterior limiting membrane rupture, accompanied by hypertrophy of the membrane at the defect margins. Beyond keratocytes, the cellular composition of the scar included fibroblasts, atypical for normal corneal tissue, responsible for the synthesis of fibrous elements and proteoglycans, as well as myofibroblasts, whose contractile properties contribute to maximal scar compaction. Thus, corneal repair is accompanied by challenges in the form of reduced transparency, linked to stromal disorganization, and the emergence of optical aberrations induced by the contraction of fibrous tissue during its remodeling within the scar site.

References

  1. Wong TY, Klein BE, Klein, R. The preva-lence and 5-year incidence of ocular trauma. The Beaver Dam Eye Study. Ophthalmology. 2000;107(12):2196–202. https://doi.org/10.1016/s0161-6420(00)00390-0
  2. Katz J, Tielsch JM. Lifetime prevalence of ocular injuries from the Baltimore Eye Sur-vey. Archives of ophthalmology. 1993;111(11):1564–8. https://doi.org/10.1001/ ar-chopht.1993.01090110130038
  3. Agrawal VB, Tsai RJ.Corneal epithelial wound healing. Indian journal of ophthalmology. 2003;51(1):5–15.
  4. Chin JY, Liu C, Lee IXY, Lin MTY, Cheng CY, Wong JHF, Teo CL, Mehta JS, Liu YC. Impact of Age on the Characteristics of Corneal Nerves and Corneal Epithelial Cells in Healthy Adults. Cornea. 2024;43(4):409–18. https://doi.org/10.1097/ICO.0000000000003363
  5. Eraslan M, Toker E. Mechanisms of corneal wound healing and its modulation follwing refrac-tive surgery. Marmara Med. J. 2009;22:169–78.
  6. Sutphin J.E. Basic and Clinical Science Course. 1st. American Academy of Opthalmology; External Disease and Cornea. San Fransisco, CA, USA: 2011–2012. 458 p.
  7. Germain L, Carrier P, Auger FA, Salesse C, Guérin SL. Can we produce a human corneal equiv-alent by tissue engineering?. Progress in retinal and eye research. 2000;19(5):497–527. https://doi.org/10.1016/s1350-9462(00)00005-7
  8. Guérin LP, Le-Bel G, Desjardins P, Couture C, Gillard E, Boisselier É, Bazin R, Germain L, Guérin SL. The Human Tissue-Engineered Cornea (hTEC): Recent Progress. International journal of molecular sciences. 2021;22(3):1291. https://doi.org/10.3390/ijms22031291
  9. Gouveia RM, Connon CJ. The effects of ret-inoic acid on human corneal stromal keratocytes cultured in vitro under serum-free conditions. Inves-tigative ophthalmology & visual science. 2013;54(12):7483–91. https://doi.org/10.1167/iovs.13-13092
  10. Skuta GL, Cantor LB, Weiss JS. Refractive Surgery, Section 13 Basic and Clinical Science Course. 1st. American Academy of Opthamology; San Fransisco, CA, USA. 2011:2–44.
  11. Lim M, Ye H, Panoskaltsis N, Drakakis EM, Yue X, Cass AE, Radomska A, Mantalaris A. Intel-ligent bioprocessing for haemotopoietic cell cultures using monitoring and design of experi-ments. Biotechnology advances. 2016;25(4):353–68. https://doi.org/10.1016/j.biotechadv.2007.02.002
  12. Mirveis Z, Howe O, Cahill P, Patil N, Byrne HJ. Monitoring and modelling the glutamine meta-bolic pathway: a review and future perspec-tives. Metabolomics. Official journal of the Metabo-lomic Society. 2023;19(8):67. https://doi.org/10.1007/s11306-023-02031-9
  13. Bron A. The architecture of the corneal stroma. Br. J. Ophthalmol. 2001;85:379–381. doi: 10.1136/bjo.85.4.379.
  14. Komninou MA, Seiler TG, Enzmann V. Corneal biomechanics and diagnostics: a re-view. International ophthalmology. 2024;44(1):132. https://doi.org/10.1007/s10792-024-03057-1
  15. Koudouna E, Winkler M, Mikula E, Juhasz T, Brown DJ, Jester JV. Evolution of the vertebrate corneal stroma. Progress in retinal and eye research. 2018;64:65–76. https://doi.org/10.1016/j.preteyeres.2018.01.002
  16. Carlson EC, Wang IJ, Liu CY, Brannan P, Kao CW, Kao WW. Altered KSPG expression by keratocytes following corneal injury. Molecular vi-sion. 2013;9:615–23.
  17. Jhanji V, Billig I, Yam GH. Cell-Free Biolog-ical Approach for Corneal Stromal Wound Heal-ing. Frontiers in pharmacology. 2021;12:671405. https://doi.org/10.3389/fphar.2021.671405
  18. West-Mays JA, Dwivedi DJ. The kerato-cyte: corneal stromal cell with variable repair pheno-types. The international journal of biochemistry & cell biology. 2006;38(10):1625–31. https://doi.org/10.1016/j.biocel.2006.03.010
  19. Torricelli AA, Santhanam A, Wu J, Singh V, Wilson SE. The corneal fibrosis response to epitheli-al-stromal injury. Experimental eye research. 2016;142:110–8. https://doi.org/10.1016/j.exer.2014.09.012
  20. Bernstein AM, Twining SS, Warejcka DJ, Tall E, Masur S.K. Urokinase receptor cleavage: a crucial step in fibroblast-to-myofibroblast differen-tiation. Molecular biology of the cell. 2007;18(7):2716–27. https://doi.org/10.1091/mbc.e06-10-0912
  21. Zhu R, Liu TW, Liu F. Exogenous Uroki-nase Inhibits Proteasomal Degradation of Its Cog-nate Urokinase Plasminogen Activator Receptor. Frontiers in pharmacology. 2022;13:754271. https://doi.org/10.3389/fphar.2022.754271

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Published

2025-04-18

How to Cite

Yuzuch , O., Dudok , O., Tverdokhlib , I., & Fik , V. (2025). Stromal-cellular aspects of corneal reparative regeneration in traumatic ocular globe injuries. Морфологія / Morphologia / Morfologìâ, 17(1), 78–83. Retrieved from https://morphology.dma.edu.ua/article/view/327201

Issue

Vol. 17 No. 1 (2023)

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