The evaluation of the effect of mitomycin–C aided and simple papillary resection by brush cytology in severe allergic keratoconjunctivitis

Abstract

Abstract: : Purpose:The percentage of conjunctival inflammatory cells has been reported to be related with the severity of corneal damage in severe ocular allergies. The pathogenesis of corneal damage is thought to be associated with the load of inflammatory cells recruited in the upper tarsal conjunctiva. We previously reported that mitomycin–C (MMC) aided papillary resection in severe ocular allergy significantly reduced the corneal recurrences compared to simple resection. To evaluate the effect of MMC aided papillary resection on conjunctival inflammation, we examined brush cytology (BC) in severe ocular allergy patients before and after surgery. Methods:Fourteen patients diagnosed with AKC or VKC were enrolled in this study. Nineteen eyes of 14 patients underwent papillary resection with MMC (13 males and 1 female: mean 16.3±8.1 years old) and 20 eyes of 14 patients had simple resection (13 males and 1 female: mean 18.4±7.8 years old). Upper tarsal conjunctival epithelial cells were collected by BC before and after the surgery within 2 weeks and the percentage of inflammatory cells was counted by microscopic observation. BC results were compared pre and postoperatively and between the 2 groups. Results:In the MMC group, the postoperative percentages of neutrophils and eosinophils were significantly reduced compared to the preoperative levels (p<0.05). No significant differences were observed in the simple resection group. Conclusions:MMC aided papillary resection was observed to be associated with reduced early postoperative inflammation in severe ocular allergies.

Keywords: cytology • conjunctiva • inflammation