“…In particular, it is unclear if the stromal thinning associated with the disease is caused by an enzyme-mediated loss of collagen (Fini et al, 1992;Kenney et al, 1989Kenney et al, , 1994Kenney and Brown, 2003;Rehany et al, 1982;Sawaguchi et al, 1990Sawaguchi et al, , 1994Sawaguchi et al, , 1989Teng, 1963;Zhou et al, 1998), a disruption to fibrillogenesis due to the presence of defective keratocytes (Brookes et al, 2003;Kim et al, 1999;Sherwin et al, 2002;Somodi et al, 1996) or abnormal proteoglycans (Funderburgh et al, 1989), or whether it is due to slippage between lamellae resulting in a redistribution of collagen away from the apex of the cone (Polack, 1976).…”