Neural remodeling following experimental surgery of the rabbit cornea.

Wounding of the cornea results in extensive damage to the innervation that must be repaired to restore its normal structure and function. Four types of experimental wounds were produced in the corneas of young albino rabbits: 180 degrees penetrating perilimbal incisions, 4-mm central circular keratectomies and keratotomies, and radial keratotomies. Following perilimbal incisions, the denervated half of the cornea was reinnervated primarily by regenerating nerves that penetrated the limbal scar tissue. New neural growth from the innervated portion of the cornea provided a minor contribution to the denervated area. The regenerative response of the nerves following nonpenetrating procedures was found to be a biphasic process. In the first phase, a short period of degeneration of all nerves within the area enclosed by the wound boundary overlapped in time with the appearance of long, large caliber, dense neurites that coursed perpendicularly to the wound margins. The neurites originated from the intact subepithelial plexus at some distance from the wound margins. The second phase was initiated by the degeneration of the wound-oriented neurites and the concomitant appearance of a second generation of neurites. These new neurites originated from the transected stumps of the regenerating subepithelial axons at or near the wound margins. The oblique disposition of the second wave of neurites was similar to that of basal leashes in normal corneas. Nonpenetrating wounding procedures exhibited similar neural remodeling principles. In both types of keratotomies, nerve endings terminated within the wound in enduring and densely packed neuroma-like arrangements, while in keratectomies, nerve endings continued to grow toward the center of the cornea.