TEAR RESPONSE TO CORNEAL TRAUMA

The rate of inflammatory cell infiltration into the tear, the number of the
cells and the nature of the cells following two different lesions in the
cornea will be compared. Inflammatory cells appear in the tear film after
trauma to the cornea, and are important in the healing processes of the
traumatized cornea. I plan to examine the cellular infiltration following
radial keratotomy (RK), an example of a surgically induced corneal trauma
generally leading to an uneventful healing process. The cellular
infiltration caused by RK will be compared to that caused by a thermal
burn, a corneal trauma that can be a model for corneal ulceration. From
these studies, I hope to determine whether differences in the rate, numbers
or types of inflammatory cells infiltrating the tear film is predictive of
the healing process. RK differs from other corneal surgeries such as penetrating keratoplasty or
cataract surgery. In these latter surgeries, the goal has been to produce
closely apposed wound margins and return the cellular interfaces to their
presurgical relationships. In marked contrast, the surgeon's goal in
performing RK is to encourage an altered corneal curvature by the formation
of scar tissue. The process of wound healing is critical to the success of
the procedure. The timely appearance of the appropriate inflammatory cells
are an important aspect of the wound healing that can be easily measured
and quantified. As RK becomes more widely used, it is probable that
unusual responses to the surgery will appear. Also, new techniques for
conducting the surgery, such as the use of lasers, will need to be
evaluated. The inflammatory response as measured by changes in tear
cellular infiltration could be used to evaluate unusual patient reactions
to the procedure as well as to test new techniques and medications once
baseline values have been established.