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.
