title: Histopathology of Conjunctivochalasis Compared to Normal Conjunctiva.
abstract: OBJECTIVE
  To evaluate the histopathologic changes in the conjunctiva of patients with conjunctivochalasis (CCh) compared to age-matched controls.
  
  
  METHODS
  This cross-sectional, controlled study included 27 eyes of 27 patients with CCh and 16 eyes of 16 age-matched controls. A biopsy of the bulbar conjunctiva was performed along the temporal lower lid margin before cataract surgery in both groups. Histopathologic evaluation of the specimens was done with light microscopy using staining with hematoxylin/eosin, periodic acid Schiff, and van Gieson elastic stain. Various histopathologic features of the conjunctival epithelium and stroma were compared between the two groups.
  
  
  RESULTS
  The mean age of patients was 62.4 ± 6.9 years in the CCh group and 65.1 ± 6.3 years in the control group (P= 0.54). No significant differences were noted between the two groups in terms of conjunctival epithelial changes including papillomatosis, epithelial clefts, epithelial goblet cells, or infiltration of inflammatory cells. Mean thickness of the conjunctival stroma was 0.21 ± 0.08 mm in the CCh group and 0.26 ± 0.21 mm in the control group (P= 0.10). For the conjunctival stroma, there were no significant differences between the two groups in terms of elastosis, fibrosis, lymphangiectasia, or infiltration of inflammatory cells.
  
  
  CONCLUSIONS
  No noticeable differences were found in the histopathologic features by light microscopy between eyes with CCh and those of age-matched controls. Therefore, the primary pathology of CCh may not be within the conjunctiva itself. Instead, loose attachment of the conjunctiva to the underlying tissue may be the reason for the redundant folds in the bulbar conjunctiva.
authors.affiliation: Farabi Eye Hospital, Eye Research Center, Tehran University of Medical Sciences, Tehran, Iran.
authors.forename: Hesam
authors.initials: H
authors.lastname: Hashemian
authors.affiliation: Noor Ophthalmology Research Center, Noor Eye Hospital, Tehran, Iran.
authors.forename: Mirgholamreza
authors.initials: M
authors.lastname: Mahbod
authors.affiliation: Farabi Eye Hospital, Eye Research Center, Tehran University of Medical Sciences, Tehran, Iran.
authors.forename: Fahimeh A
authors.initials: FA
authors.lastname: Amoli
authors.affiliation: Farabi Eye Hospital, Eye Research Center, Tehran University of Medical Sciences, Tehran, Iran.
authors.forename: Mohammad Y
authors.initials: MY
authors.lastname: Kiarudi
authors.affiliation: Farabi Eye Hospital, Eye Research Center, Tehran University of Medical Sciences, Tehran, Iran.
authors.forename: Mahmoud
authors.initials: M
authors.lastname: Jabbarvand
authors.affiliation: Department of Ophthalmology, Massachusetts Eye and Ear Infirmary, Harvard Medical School, Massachusetts, Boston, USA.
authors.forename: Ahmad
authors.initials: A
authors.lastname: Kheirkhah
keywords: Conjuctivochalsis; Conjunctiva; Histopathology; Tenon's Capsule