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. 2022 Oct 3;10:953590. doi: 10.3389/fbioe.2022.953590

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Copyright © 2022 Yang, Zhang, Tan and Wang.

This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

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Impact of tensile and/or compressive stresses. (A) Native cornea is mainly subjected to tangential tensile (parallel to the plane of the cornea) stress and radial compressive stress within the entire corneal thickness. (B) Mechanical strains in the physiological range (∼3%) maintain a normal keratocyte phenotype, decrease keratocyte–fibroblast–myofibroblast (KFM) transformation, and inhibit the synthesis of proteases to maintain normal stromal structure. However, larger magnitude strains (∼15%) upregulate the expression of proteases and contribute to extracellular matrix (ECM) disorganization. (C) Mechanical compression stress indirectly controls stromal hydration and thickness by modulating the pump function of the corneal endothelium. Moreover, it also directly influences stromal structure by altering cell morphology, inhibiting proliferation, and promoting apoptosis and extracellular matrix (ECM) degradation in the stroma.