The dissertation addresses a relevant issue in ophthalmology - improving the effectiveness of treatment for non-penetrating corneal injuries (traumatic and recurrent erosions) by studying markers of the extracellular matrix in tear fluid and methods of their correction.
The rationale for choosing the research topic is based on the staggering statistics provided by the World Health Organization, which registers 55 million cases of eye injuries annually, resulting in activity limitation for more than one day per year for the individuals affected, and 750,000 cases requiring hospitalization each year [1-5].
In the structure of primary visits for urgent ophthalmic care, corneal injuries occupy a prominent place. Approximately 45% of visits are due to traumatic corneal erosions, while foreign bodies on the cornea account for around 31% of visits [1117]. The prevalence of corneal injuries is higher among working-age individuals, leading to temporary disability and posing a significant medical and social problem.
Even minor traumatic damage to the cornea can lead to morphological changes and disrupt its functional properties. The cornea is an interesting organ for studying the mechanism of wound healing and interaction such as stromal-epithelial, stromal-endothelial due to its transparency and accessibility for manipulation and visualization. Barrier protection, light refraction and ultraviolet light filtration are the main functions of the cornea to maintain normal vision. Because the cornea is the primary refractive surface of the eye, even minor changes in its structure lead to vision problems. The corneal epithelium is maintained in a complex balance that can be easily disturbed. Corneal trauma can result in varying degrees of opacity depending on the magnitude of the cellular and molecular response to the injury [1, 3, 7, 18, 19, 21, 24].
On the other hand, after corneal injury, a condition may arise where the corneal epithelium is unable to regenerate and form adhesive complexes with the basement membrane for various reasons. Such conditions include persistent epithelial defects and recurrent corneal erosions (RCE) [3, 18, 19, 21-27]. RCE is characterized by the spontaneous appearance of corneal epithelial defects that last from several hours to several days, resulting in loss of productivity and decreased quality of life, necessitating prolonged conservative treatment.
Corneal wound healing is a complex process consisting of three overlapping phases, including cell migration/inflammation, cell proliferation/differentiation, and matrix remodeling. Chronic or prolonged hypoxia resulting from trauma can disrupt cellular homeostasis, induce inflammation, and alter the protein composition of the tear film [91, 97, 99, 102-105].
