Conjunctival cytologic features in anophthalmic patients wearing an ocular prosthesis.
OBJECTIVE
To evaluate the cytologic features of conjunctival epithelium in anophthalmic sockets with an ocular prosthesis, using an impression cytology technique and to determine the clinical factors associated with these changes.


METHODS
In a prospective case-controlled study, 40 consecutive unilateral anophthalmic patients who wore an ocular prosthesis were recruited. A questionnaire on the care of the prosthesis included total wearing period, frequency of cleaning, frequency of polishing, cleaning solution, and eye drop use. The degree of inflammation of the anophthalmic conjunctival socket was evaluated. Impression cytology specimens were taken from the upper tarsal conjunctiva, the bulbar conjunctiva, and the lower tarsal conjunctiva of each socket, and from the contralateral eye (to serve as an internal matched control). The goblet cell density and the nucleus-to-cytoplasm ratio of the epithelial cells were measured. The relevance of these conjunctival cytologic features to the various factors of prosthesis care or conjunctival inflammation was analyzed.


RESULTS
In the anophthalmic sockets, the conjunctiva showed squamous metaplasia at all 3 areas sampled. The goblet cell density was significantly decreased and the nucleus-to-cytoplasm ratio of the epithelial cells was significantly increased compared with the control eyes (p<0.05, on all 3 areas sampled, Wilcoxon signed rank test). These conjunctival cytologic changes were not significantly associated with total wearing time, frequency of polishing, cleaning solution, or eye drops use (p>0.05, Spearman's correlation test).


CONCLUSIONS
Squamous metaplasia with decreased goblet cell density and increased nucleus-to-cytoplasm ratio occurred in anophthalmic conjunctival sockets but was not associated with particular aspects of prosthesis care.
Kim
Jong Hyun
JH
S-Eye Center, Ansan, Korea.
Lee
Min Joung
MJ
Choung
Ho-Kyung
HK
Kim
Nam Ju
NJ
Hwang
Sang-won
SW
Sung
Mi Sun
MS
Khwarg
Sang In
SI
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000853:Anophthalmos / Q000628:therapy*; D016022:Case-Control Studies; D002452:Cell Count; D003228:Conjunctiva / Q000473:pathology*; D003233:Conjunctivitis, Allergic / Q000175:diagnosis* / Q000209:etiology; D004203:Disinfection / Q000379:methods; D004847:Epithelial Cells / Q000473:pathology*; D005137:Eye, Artificial / Q000009:adverse effects*; D005260:Female; D005549:Foreign-Body Reaction / Q000175:diagnosis* / Q000209:etiology; D020397:Goblet Cells / Q000473:pathology*; D006801:Humans; D008297:Male; D008679:Metaplasia; D008875:Middle Aged; D011446:Prospective Studies; D011795:Surveys and Questionnaires