We compared corneal wound healing in 25 clear transplants with 26 keratotomy specimens and sutured and unsutured corneal wounds in a monkey model. Monkey wounds healed faster than human wounds, but healing time within the same species varied. Sutured wounds were characterized by subepithelial fibroplasia, recovery of collagen fiber continuity and absence of epithelial plugs. Unsutured wounds had no subepithelial fibroplasia but had fibroblasts and collagen fiber orientation parallel to wounds. Unsutured wounds in corneas containing sutures had subepithelial fibroplasia, and fibroblast orientation and fiber deposition parallel to the wound. Epithelial ingrowth and incarceration of Bowman's layer and/or Descemet's membrane in unsutured wounds appeared to disrupt wound healing. Abnormalities in wound healing in sutured or unsutured wounds are associated with lamellar distortion, a modified inflammatory response, and individual wound healing responses.