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Soo Jeong Ryu, Sang Beom Han, Hee Kyung Yang, Won Ryang Wee, Joon Young Hyon; Squamous Metaplasia May Persist after Pterygium Excision and Limbal-Conjunctival Autograft. Invest. Ophthalmol. Vis. Sci. 2013;54(15):2126.
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© ARVO (1962-2015); The Authors (2016-present)
To investigate the changes of conjunctival epithelium at the pterygium and donor graft sites after pterygium excision and limbal-conjunctival autograft.
This is a prospective study that included 16 eyes of 15 patients. Impression cytology specimens were obtained preoperatively and at 1, 3 and 6 months postoperatively, at the site of the pterygium and donor graft site, respectively. In each specimen, changes of conjunctival epithelium were evaluated using the nucleus-to-cytoplasm(N/C) ratio and goblet cell density (GCD). Morphologic changes of cell and nucleus were also evaluated.
Preoperatively, Both N/C ratio and GCD were significantly higher in specimens from pterygium site than those from graft harvest site. At both sites, GCD decreased rapidly at 1 month after surgery, but showed gradual recovery. No significant difference in GCD was found between the two sites at postoperative 1, 3 and 6 months. Although there was no significant difference in the N/C ratio at 1 and 3 month, pterygium site showed significantly higher N/C ratio than donor graft site at 6 months. At postoperative 6 months, changes suggesting squamous metaplasia elongation of the cells and pyknotic changes in the nuclei-was noticed in 5 samples from the pterygium site, although these changes were never found at donor graft site.
Conjunctival epithelial metaplasia may persist even after pterygium removal and limbal reconstruction. Restoration of limbal barrier function may prevent the corneal involvement of the metaplastic conjunctival epithelial cells.
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