title: Impression cytology findings in bullous keratopathy.
abstract: OBJECTIVE
  To evaluate, by impression cytology (IC), the cytological features of the central area of corneal epithelial surface of patients with symptomatic bullous keratopathy (BK). Design Cross-sectional observational case series.
  
  
  METHODS
  IC of the central cornea was performed in 72 eyes of 72 patients with symptomatic BK between June 2005 and December 2006. Patients were divided into two groups according to the presence (group GC) or not of goblet cells (group NGC). The diagnosis of limbal stem cell deficiency (LSCD) was defined by the presence of one or more intact goblet cells on the corneal surface. Squamous metaplasia was classified according to Murube and Rivas.
  
  
  RESULTS
  Epithelial squamous metaplasia was found in 72 (100%) eyes, along with conjunctival goblet cells in 25 (34.72%) eyes. Squamous metaplasia was grade 1 in group GC and more advanced grades in group NGC. Corneal neovascularisation was present in 62 (82.11%) eyes. Vessel measure was more than 4 mm in 11 eyes (23.4%) in group NGC and 10 eyes (40%) in group GC (p=0.559), and they were mostly subepithelial in 23 eyes (48.9%) in group NGC and 12 (48%) eyes in group GC (p=0.822).
  
  
  CONCLUSIONS
  Squamous metaplasia was the most frequent finding associated with advanced BK. The presence of goblet cells on the surface of corneas with squamous metaplasia grade 1, in a significant number of patients, suggests that limbal stem cell deficiency is a common condition associated with advanced cases of BK.
authors: Federal University of São Paulo, Marília-SP, Brazil. dra@fabianaparis.com.br
authors: Fabiana dos Santos
authors: Fdos S
authors: Paris
authors: Eliana Domingues
authors: ED
authors: Gonçalves
authors: Jeison de Nadai
authors: Jde N
authors: Barros
authors: Mauro Silveira de Queiroz
authors: MS
authors: Campos
authors: Elcio Hideo
authors: EH
authors: Sato
authors: José Alvaro Pereira
authors: JA
authors: Gomes
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003316:Corneal Diseases / Q000473:pathology*; D016510:Corneal Neovascularization / Q000473:pathology; D003430:Cross-Sectional Studies; D003581:Cytodiagnosis / Q000379:methods; D003941:Diagnostic Techniques, Ophthalmological; D019573:Epithelium, Corneal / Q000473:pathology*; D005260:Female; D020397:Goblet Cells / Q000473:pathology; D006801:Humans; D016850:Limbus Corneae / Q000473:pathology; D008297:Male; D008679:Metaplasia / Q000473:pathology; D008875:Middle Aged; D013234:Stem Cells / Q000473:pathology; D055815:Young Adult