What is the initial step for healing descemetoceles?

The initial step for healing descemetoceles primarily involves corneal epithelialization. Descemetoceles are deep corneal ulcers that present with a significant loss of corneal stroma and expose Descemet's membrane. The healing process begins with the migration and proliferation of corneal epithelial cells at the edges of the ulcer, which covers the exposed areas and helps restore the integrity of the cornea. This epithelial cell activity is crucial in preventing further infection and facilitating the healing process.

While vascular ingrowth can play a role in the later stages of healing by providing necessary nutrients and promoting the formation of granulation tissue, it is not the first step. Similarly, granulation tissue formation occurs after the initial repair processes and can be influenced by factors such as inflammation and vascular supply.

Reduction of inflammation is important for the healing process but is not the first step that occurs in the restoration of the corneal surface. The primary focus in the early stages of healing a descemetocele is on epithelialization, which lays the groundwork for the subsequent healing events.