From the Department of Ophthalmology, University of Washington School of Medicine, Seattle, Washington, U.S.A.
Address correspondence and reprint requests to Dr. S.E. Wilson, Department of Ophthalmology, University of Washington School of Medicine, Box 356485, Seattle, WA 98195-6485, U.S.A.
Anterior keratocytes undergo apoptosis in response to epithelial injury. This likely represents mechanical activation of systems that vigilantly monitor the corneal epithelium for injury produced by pathogenic viruses. Keratocyte apoptosis is the first change noted after procedures in which the epithelium is injured and may be an initiator of the subsequent wound healing cascade. The working hypothesis is that inhibition of keratocyte apoptosis will limit the subsequent wound healing response. The keratocyte apoptosis response varies with the specific type of epithelial injury induced by a particular refractive surgical procedure, such as photorefractive keratectomy or laser in situ keratomileusis. Continuing efforts aim to identify pharmacological agents that effectively inhibit keratocyte apoptosis without promoting keratocyte necrosis.