“…The environmental factors may include endogenous and exogenous factors, such as glucocorticoid, hydrogen peroxide, and reactive oxygen species (ROS) ( 120 ). The gene mutations or variants involved in collagen ( 57 , 61 , 64 , 67 , 75 , 76 , 78 , 88 ), metallopeptidase inhibitor ( 75 , 81 , 109 , 157 ), lysyl oxidase ( 18 , 30 , 81 , 90 ), metallopeptidase ( 64 ), antioxidant enzyme ( 16 , 25 , 81 , 199 ), inflammatory cytokines ( 11 , 45 , 83 , 201 ), and others cause insufficient protein dosage or abnormal function. These genetic changes, together with the aforementioned stimulation, lead to the changes in related functions and pathways in the corneal cells.…”