title: Clinical and Cytologic Evidence of Limbal Stem Cell Deficiency in Eyes With Long-Standing Vernal Keratoconjunctivitis.
abstract: OBJECTIVE
  We aimed to study the impression cytology (IC) of the ocular surface in eyes with vernal keratoconjunctivitis (VKC) and clinical evidence of limbal stem cell deficiency (LSCD).
  
  
  METHODS
  This is a prospective comparative study.
  
  
  METHODS
  This study included 78 eyes of 40 patients with VKC. Limbal stem cell deficiency was diagnosed clinically based on the presence of corneal findings such as dull irregular epithelial reflex, superficial neovascularization, conjunctivalization, and loss of limbal palisades of Vogt. The study group consisted of 28 eyes of 15 patients with clinically diagnosed LSCD and control group of 50 eyes of 25 patients without LSCD. Conjunctival and corneal IC was done in all eyes. Presence of goblet cells in the corneal samples on IC was considered confirmatory of LSCD.
  
  
  RESULTS
  Compared with controls, patients with LSCD were older and had longer duration of disease. On IC, goblet cells were present on the cornea in 53.6% of eyes with clinically diagnosed LSCD and in none of the control eyes (P < 0.0001). Clinically diagnosed LSCD in study eyes correlated with cytologic findings of greater conjunctival squamous metaplasia, decreased conjunctival goblet cells, greater corneal cell metaplasia, and increased inflammation as compared with control eyes.
  
  
  CONCLUSIONS
  Most of the eyes with VKC and clinical evidence of LSCD have cytologic evidence of LSCD with goblet cells on the cornea.
authors.affiliation: From the *Corneal and Anterior Segment Service, L V Prasad Eye Institute, Kallam Anji Reddy Campus; †Sudhakar and Sreekanth Ravi Stem Cell Biology Laboratory, Hyderabad Eye Research Foundation; and ‡Prof Brien Holden Eye Research Centre and §Ophthalmic Pathology Service, L V Prasad Eye Institute, Kallam Anji Reddy Campus, Hyderabad, India.
authors.forename: Ujwala S
authors.initials: US
authors.lastname: Saboo
authors.forename: Sayan
authors.initials: S
authors.lastname: Basu
authors.forename: Shubha
authors.initials: S
authors.lastname: Tiwari
authors.forename: Ashik
authors.initials: A
authors.lastname: Mohamed
authors.forename: Geeta K
authors.initials: GK
authors.lastname: Vemuganti
authors.forename: Virender S
authors.initials: VS
authors.lastname: Sangwan