Keratocytes are specialised cells that produce and maintain corneal stromal matrix and play a key role in corneal wound healing. Abnormal functioning of these cells is likely to play a central role in corneal disorders, such as
keratoconus, which in many cases leads to corneal
blindness if untreated. The genetic basis of
keratoconus is poorly understood but it is likely that apoptosis pathways are involved. The current paper proposes a novel hypothesis for the treatment and prevention of corneal
blindness in disorders such as
keratoconus as an alternative to the gold standard treatment of penetrating or partial thickness
keratoplasty. The proposed hypothesis involves the isolation, purification and
transplantation of keratocyte progenitor cells (KPC), with introduction into stroma via femtosecond
laser channels in diseased corneal stroma using a carrier medium. The success of this approach will depend upon the viability, migration, and cell division of introduced KPC and production of normal stromal matrix. Results from previous studies suggest that cellular
transplantation is possible and may lead to healthy stromal matrix production and remission of a disease phenotype in patients affected with disorders such as
keratoconus. If the current hypothesis proves to be correct, it may offer an alternative to invasive
keratoplasty for treatment of corneal disorders such as
keratoconus that cause significant morbidity for millions of people worldwide.