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III. Injections and Lasers > Corneal Anatomy, Wound Healing (M) > Flashcards

Corneal Anatomy, Wound Healing (M) Flashcards

1
Q

What layer of the epithelial basement membrane has laminin accumulation? 1. Is it more anterior or posterior to the other lamina? 2

A
  1. lamina lucida

2. anterior

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2
Q

What are the four phases in wound healing for the corneal epithelium?

A
  1. latency
  2. migration
  3. proliferation
  4. attachment
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3
Q

What are the processes that occur during the attachment phase of corneal epithelial wound healing?

A
  1. hemidesmosomes to BM

2. may take up to a year

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4
Q

What are the processes that occur during the latent phase of corneal epithelial wound healing?

A
  1. Cells transform to prepare for migration
  2. Apoptosis for damaged cells – shed into tears
  3. Fibronectin increases on wound bed
  4. Epithelial cells bind via integrins (surface proteins)
  5. Basal cells remove hemidesmosomes
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5
Q

What does a lumican deficiency lead to?

A

early opacification

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6
Q

What happens to keratocytes following insult?

A

change into myofibroblasts and produce ECM, MMPs, and cytokines

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7
Q

What are thickenings in the central Descemet’s membrane called?

A

guttata

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8
Q

How do bullae form?

A

corneal edema, often after cataract surgery

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9
Q

What type of collagen is in the banded zone of Descemets? 1. Non banded zone? 2

A
  1. type VIII

2. type IV

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10
Q

What type of collagen is in the Bowman’s membrane?

A

type I and III

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11
Q

What are the processes that occur during the proliferation phase of corneal epithelial wound healing?

A
  1. Cell mitosis initially by transient amplifying cells (TACs) – basal stem cells
  2. Slow cycling stem cells then proliferate
  3. Cells then differentiate to wing and surface cells
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12
Q

What are the benefits of the amniotic membrane?

A
  1. Serves as a substrate for epithelial growth
  2. Promotes epithelialization
  3. Supresses inflammation
  4. Inhibits angiogenesis
  5. Antimicrobial
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13
Q

What is fibrin and fibronectin important for?

A

hemidesmosomes and healing

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14
Q

What is released from injured epithelium?

A

cytokines

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15
Q

What effect does TGFβ from the epi after insult have on the stroma?

A
  1. Stimulates underlying keratocytes to migrate and morph into myofibroblasts
  2. reduced transparency
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16
Q

What are thickenings in the peripheral Descemet’s membrane called?

A

Hassall-Henle

17
Q

When can there be a Descemet’s membrane detachment?

A
  1. DMEK

2. DALK

18
Q

What is the blood component that remains after clotting that can can be used as tears?

A

autologous tears (serum)

19
Q

What are the processes that occur during the migration phase of corneal epithelial wound healing?

A
  1. Basal cells flatten and spread to a monolayer
  2. Centripetal
  3. Contraction of actin filaments = movement
  4. Fibronectin dissipates
20
Q

What effect does IL-1 from the epi after insult have on the stroma?

A
  1. Stimulates keratocyte synthesis of Fas-ligand

2. Fas-ligand binds to other keratocyte Fas receptors = Apoptosis (minimal collateral damage)

21
Q

What is the surgical application of Dua’s layer?

A

helps prevent endothelial transplants from scrolling up and may help prevent haze

22
Q

What type of drug is needed to penetrate the cornea to the anterior chamber?

A

amphipathic

23
Q

Why does LASIK have less post-op haze than PRK?

A

harm little epi of less release of migrating factors and cytokines

24
Q

What does epidermal growth factor do in corneal epi wound healing?

A
  1. Promotes epithelial cell proliferation and wound closure

2. Encourages fibronectin deposition

25
Q

What does a keratocan mutation lead to?

A

cornea plana (abnormal curvature)

26
Q

What effect does TGFα from the epi after insult have on the stroma?

A

Triggers stromal infiltration; phagocytosis of debris

27
Q

What are the types of GAGs in the corneal stroma?

A

2/3 keratan

1/3 chondroitin

28
Q

What does transforming growth factor (TGFβ) do in corneal epi wound healing?

A
  1. Encourages binding to fibronectin

2. Promotes migration

29
Q

What are the major two collagen types in the stroma? 1. What are the others? 2

A
  1. type I and VI

2. type III and IV

30
Q

What is the water content of the cornea?

A

78%

31
Q

Is the cornea normally prolate or oblate in shape? 1. After LASIK? 2

A
  1. prolate

2. oblate

32
Q

What do autologous tears contain to help the eye?

A
  1. Epidermal growth factor
  2. Fibronectin
  3. Neurotrophic growth factor
  4. Vitamin A
33
Q

What layer of the epithelial basement membrane has type IV accumulation? 1. Is it more anterior or posterior to the other lamina? 2

A
  1. lamina densa

2. posterior

34
Q

What is used after LASIK because it blocks DNA synthesis and therefore mitosis, stops myofibroblast formation?

A

mitomycin C

III. Injections and Lasers (19 decks)

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