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A. Komuro, N. Yokoi, K. Maruyama, S. Kinoshita; The Long–Term Results of a New Surgical Procedure for Treating Superior Limbic Keratoconjunctivitis . Invest. Ophthalmol. Vis. Sci. 2006;47(13):266.
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© ARVO (1962-2015); The Authors (2016-present)
To evaluate the long–term results of a new surgical procedure for treating superior limbic keratoconjunctivitis (SLK).
Fourteen eyes of 11 patients (4 male and 7 female; 52.5 yrs) who received a new surgical procedure which includes a crescent excision of the distal part of the abnormal conjunctival area (postoperative follow–up period > 2 years) were enrolled in this study. Postoperative complications, recurrence of SLK, wettability of conjunctiva, and existence of goblet cells were evaluated. The wettability of the superior limbic conjunctiva was evaluated by observing the fluidity of tear film lipid layers using tear film interferometer DR–1® (Kowa, Japan), and the fluidity was evaluated as good (smooth fluidity assuring a wettable surface) or poor (unsmooth fluidity implying an unwettable surface). Within the same lesion where the DR–1® observation was performed, impression cytology was also performed to evaluate goblet cells.
The average follow–up period was 3.0±0.7 (SD) yrs (2.1–4.5 yrs). All cases had no complications or recurrence of SLK. The wettability of the diseased conjunctiva was poor in all cases before surgery, but good in all cases post surgery; this included 2 cases with punctual occlusion by punctual plugs because of aqueous tear deficiency. Impression cytology disclosed the loss of goblet cells in all cases before surgery. In contrast, in 8 eyes out of 14 postoperative eyes, goblet cells were demonstrated. Average duration to appear goblet cells was 10.7 months.
The new surgical treatment for SLK was considered to be an effective and safe treatment in the long term, since this treatment led to normal differentiation and an improved wettability of epithelium at diseased areas without the recurrence of SLK.
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