Document Detail

Long-standing bullous keratopathy is associated with peripheral conjunctivalization and limbal deficiency.
MedLine Citation:
PMID:  16647124     Owner:  NLM     Status:  MEDLINE    
OBJECTIVE: To investigate whether peripheral corneal neovascularization in bullous keratopathy (BK) is due to conjunctivalization, a sign of limbal stem cell deficiency. DESIGN: Observational case-control study. PARTICIPANTS: Sixteen BK patients. METHODS: Patients were divided into 2 groups: BK without peripheral neovascularization [NV(-) group; 5 patients, 5 eyes] and BK with neovascularization [NV(+) group; 11 patients, 13 eyes]. Evidence of conjunctivalization was evaluated by periodic acid-Schiff staining of impression cytology samples from the peripheral vascularized cornea. The 2 groups' durations of disease also were compared. Penetrating keratoplasty (PK) was performed in all 16 cases, and the 2 groups' durations of reepithelialization after PK were compared. MAIN OUTCOME MEASURES: Presence of goblet cells using impression cytology, duration of BK, and duration of postoperative reepithelialization. RESULTS: Goblet cells were found on the peripheral corneal surface in all eyes in the NV(+) group. However, all eyes in the NV(-) group were negative for goblet cells (P<0.0001). Duration of disease was 14.4+/-5.4 months in the NV(-) group and 66.2+/-65.5 months in the NV(+) group (P = 0.030). Duration of postoperative epithelialization was 6.2+/-2.2 days in the NV(-) group and 28.8+/-36.5 days in the NV(+) group (P = 0.046). CONCLUSION: Conjunctivalization of the peripheral cornea and delayed postoperative epithelialization in BK patients with NV suggest the presence of limbal stem cell deficiency in such patients. Patients with long-standing disease were found to be more prone to neovascularization. For this reason, early surgery may lead to a better surgical outcome.
Yuichi Uchino; Eiki Goto; Yoji Takano; Murat Dogru; Naoshi Shinozaki; Shigeto Shimmura; Yukiko Yagi; Kazuo Tsubota; Jun Shimazaki
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't     Date:  2006-05-02
Journal Detail:
Title:  Ophthalmology     Volume:  113     ISSN:  1549-4713     ISO Abbreviation:  Ophthalmology     Publication Date:  2006 Jul 
Date Detail:
Created Date:  2006-07-03     Completed Date:  2006-07-20     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  7802443     Medline TA:  Ophthalmology     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1098-101     Citation Subset:  IM    
Department of Ophthalmology, Tokyo Dental College, Chiba, Japan.
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MeSH Terms
Case-Control Studies
Conjunctiva / pathology*
Corneal Diseases / diagnosis*,  surgery
Corneal Neovascularization / diagnosis,  surgery
Cytological Techniques
Epithelium, Corneal / pathology*
Goblet Cells / pathology
Keratoplasty, Penetrating
Limbus Corneae
Middle Aged
Periodic Acid-Schiff Reaction
Retrospective Studies
Stem Cells / pathology*

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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