The Interrelationship of Metabolism and Deturgescence of the Living Cornea

¹ Wilmer Institute, Johns Hopkins University School of Medicine Baltimore, Md.

It is the purpose of this paper to review recent investigations, including some unpublished studies on the metabolic and physiologic dependence of small areas of stroma on the overlying cells, with the object of assessing the extent to which they have contributed to a fuller understanding of the mechanism by which aerobic metabolism maintains the deturgescence of the corneal stroma. The recent findings and conclusions of Herrmann on the metabolic interaction between the epithelium and underlying stroma are given. His contention that there is a structural linear metabolic interrelationship is discussed in the light of Langham and Pollack's observations that separation of stroma from either the overlying epithelium or its underlying endothelium by an impermeable thin polypropylene sheet neither decreases the ability of the isolated stroma to incorporate radioactive sulfate nor causes physiologic changes over periods of many weeks. In attempting to explain the specificity of the metabolic changes in the stroma after removal of epithelial or endothelial cells, attention is given particularly to the changes in swelling properties of corneal stroma that occur in the area lying immediately below or above the denuded layer. Thus, it is concluded that a decreased uptake of compounds by the stroma is associated with a change in swelling properties of the tissue and is not a direct effect of loss of epithelium.