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Anatomy and Physiology: Considerations in Relation to Transplantation

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Corneal Transplantation

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Abstract

Over the past decade, corneal transplantation has evolved rapidly from full-thickness penetrating keratoplasty toward partial-thickness or lamellar keratoplasty. Lamellar corneal surgery is in continuous evolution, which requires an understanding of the structural, biomechanical, and histological characteristics of corneal layers involved. In this chapter, we describe the anatomy and physiology of the human cornea in order to provide the structural basis for understanding the newly developed techniques. The chapter provides detailed information on morphological, histological, ultrastructural, and physiological characteristics of the five anatomical corneal layers, i.e., epithelium, Bowman’s layer, corneal stroma consisting of regularly arranged collagen fibrils interspersed with keratocytes, Descemet’s membrane, and endothelial cells, in relation to corneal transplantation. In particular, it outlines regional and age-related differences in structure, biomechanical properties, mechanisms of wound healing and restoration of corneal transparency, causes of stromal haze, cleavage planes and interface characteristics in lamellar transplantation techniques, and reasons for graft failure. Patterns of corneal innervation and the molecular mechanisms of antiangiogenic and immune privileges, which determine the success of allogeneic corneal transplantation, are described in addition.

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Authors and Affiliations

  1. Department of Ophthalmology, University of Erlangen-Nürnberg, Erlangen, Germany

    Ursula Schlötzer-Schrehardt PhD & Friedrich E. Kruse MD

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  1. Ursula Schlötzer-Schrehardt PhD
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  2. Friedrich E. Kruse MD
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Correspondence to Ursula Schlötzer-Schrehardt PhD .

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  1. Aarhus, Denmark

    Jesper Hjortdal

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Schlötzer-Schrehardt, U., Kruse, F.E. (2016). Anatomy and Physiology: Considerations in Relation to Transplantation. In: Hjortdal, J. (eds) Corneal Transplantation. Springer, Cham. https://doi.org/10.1007/978-3-319-24052-7_2

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