Barraquer lecture. What we have learned about corneal wound healing from refractive surgery.

The refractive corneal surgical procedures achieve their effects by modifying the corneal curvature of previously unoperated healthy eyes. Combinations of corneal incisions, excisions, or the introduction of optical interfaces are utilized to achieve the intended refractive effect(s). Each of the currently practiced refractive procedures modifies the wound healing response of the cornea in ways that are different from the standard corneal wound healing studies using sutured wounds as a model. The wound healing response of the cornea to each of the refractive procedures can be responsible for some of the visual complications that have been documented to occur after these procedures. An understanding of the factor(s) associated with the wound healing response and our subsequent ability to control those factors may establish refractive corneal surgery as a major field in ophthalmology.