Fibrillin is thought to have an important role in controlling TGF-β activation and signaling in the extracellular matrix, with studies showing dysregulation of TGF-β activity contributing to the pathogenesis of MFS, with excessive levels of active TGF-β in the matrix.55, –57 Transforming growth factor–β is involved in many processes in the cornea, including keratocyte activation, myofibroblast transformation and proliferation, and wound healing.58 This evidence concerns the gene TGFB1 and Marfan syndrome.