Corneal Wound Healing, Recurrent Corneal Erosions, and Persistent Epithelial Defects

The process of corneal wound healing involves tightly regulated epithelial proliferation, differentiation, migration, and matrix remodeling. When the corneal epithelium fails to regenerate and adhere to the underlying stroma properly, recurrent corneal erosions (RCEs) and/or persistent epithelial defects (PEDs) may occur. There are many etiologies for RCEs/PEDs, but both are frequently associated with prior trauma or underlying corneal disease. While most acute erosive episodes will resolve with conservative lubrication and/or occlusive techniques such as bandage contact lenses or tarsorrhaphy, adjunctive medical and surgical approaches may be indicated and effective. However, it is often very challenging to manage nonhealing or persistent epithelial defects. As our understanding of the mechanisms of corneal epithelial homeostasis and related tissue reaction to injury continues to advance, our therapeutic regimens will become more targeted toward the underlying mechanisms.