The Role of the Immune System in Conjunctival Wound Healing After Glaucoma Surgery

• Published in: Survey of ophthalmology Vol. 45; no. 1; pp. 49 - 68
• Main Authors: Chang, L, Crowston, J.G, Cordeiro, M.Francesca, Akbar, A.N, Khaw, P.T
• Format: Journal Article
• Language: English
• Published: New York, NY Elsevier Inc 01-07-2000; Elsevier Science
• Subjects: Animals; anti-metabolites; Biological and medical sciences; Conjunctiva - immunology; Conjunctiva - pathology; Conjunctiva - surgery; conjunctival wound healing; corticosteroids; Cytokines - metabolism; fibroblasts; Filtering Surgery; Glaucoma - immunology; Glaucoma - surgery; Growth Substances - metabolism; Humans; immune system; Immune System - drug effects; Immune System - physiology; Immunosuppressive Agents - pharmacology; Lymphocytes - immunology; Lymphocytes - metabolism; Lymphocytes - pathology; macrophages; Medical sciences; Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases; Surgery of the eye and orbit; T lymphocytes; Wound Healing - drug effects; Wound Healing - immunology; T lymphocytes; fibroblasts; glaucoma surgery; macrophages; conjunctival wound healing; corticosteroids; immune system; anti-metabolites; Human; Postoperative; Cytokine; Conjunctiva; Eye; Eye disease; Treatment; Glaucoma (eye); Surgery; T-Lymphocyte; Cicatrization; Growth factor; Macrophage; Immune system
• ISSN: 0039-6257; 1879-3304
• DOI: 10.1016/S0039-6257(00)00135-1

The immune system has a fundamental role in the development and regulation of ocular healing, which plays an important role in the pathogenesis of most blinding diseases. This review discusses the mechanisms of normal wound healing, describing the animal and fetal wound healing models used to provide further insight into normal wound repair. In particular, conjunctival wound repair after glaucoma filtration surgery will be used to illustrate the contributions that the different components of the immune system make to the healing process. The potential role of macrophages, the possible regulatory effect of lymphocytes, and the important role of growth factors and cytokines in the wound healing reaction are discussed. The significance of the immune system in the pathogenesis of aggressive conjunctival scarring is addressed, particularly assessing the predisposing factors, including drugs, age, and ethnicity. The rationale behind the pharmacological agents currently used to modulate the wound healing response and the effects these drugs have on the function of the immune system are described. Finally, potential new therapeutic approaches to regulating the wound healing response are reported.