Limbal Stem Cell Deficiency in Chronic and Delayed-onset Mustard Gas Keratopathy
Received 3 February 2009; received in revised form 27 May 2009; accepted 7 July 2009. published online 16 December 2009.
Purpose
To evaluate limbal stem cell deficiency (LSCD) using impression cytology in patients with chronic and delayed-onset mustard gas keratopathy (MGK).
Design
Prospective observational case series.
Participants
Thirty-five eyes of 18 patients (all male) with MGK were included.
Methods
A consecutive series of patients with MGK underwent impression cytology. Finding of goblet cells on the corneal side of specimens was considered as LSCD. Severity of corneal clinical manifestation was graded as mild, moderate, and severe in each quadrant. Relation between impression cytology findings and clinical grading was evaluated.
Main Outcome Measures
Impression cytology findings and clinical grading.
Results
There was LSCD in at least 1 quadrant of cornea in all 35 eyes (100% of cases). No differences were found between impression cytology findings (positive vs. negative for corneal goblet cells) among different quadrants (P = 0.378). Clinical grading was the same between nasal and temporal quadrants (P = 0.266) and between superior and inferior quadrants (P = 0.263). By combining superior and inferior quadrants (vertical zone) and nasal and temporal quadrants (horizontal zone), corneal clinical grading was more severe in horizontal versus vertical zones (P<0.001). There was no relation between LSCD and corneal clinical severity (P = 0.893).
Conclusions
A varying degree of LSCD was demonstrated in all patients with chronic or delayed-onset MGK using impression cytology. Corneal clinical manifestations are more severe in nasal and temporal quadrants. There was no relation between impression cytology findings (positive vs. negative for goblet cells) and corneal clinical grading. Other factors, such as perilimbal conjunctival ischemia, may play a role.
Financial Disclosure(s)
The author(s) have no proprietary or commercial interest in any materials discussed in this article.
Available online: December 14, 2009.
1Labbafinejad Medical Center, Shahid Beheshti University (MC), Tehran, Iran
2School of Medicine, Medical Sciences/University of Tehran, Tehran, Iran
Correspondence: Medi Eslani, MD, Ophthalmic Research Center, Labbafinejad Medical Center, Boostan 9 Street, Pasdaran Avenue, Tehran 16666, Iran
Manuscript no. 2009-143.
Financial Disclosure(s): The author(s) have no proprietary or commercial interest in any materials discussed in this article.
ABSTRACT