Conjunctival Resection Combined With Tenon Layer Excision and the Involvement of Mast Cells in Superior Limbic Keratoconjunctivitis
Journal
American Journal of Ophthalmology
Journal Volume
145
Journal Issue
3
Pages
445-4520
Date Issued
2008
Author(s)
Abstract
Purpose: To evaluate the effectiveness of conjunctival resection combined with Tenon layer excision in treating superior limbic keratoconjunctivitis (SLK) and the involvement of mast cells in SLK. Design: Retrospective, interventional case series. Methods: Forty eyes of 30 SLK patients who were unresponsive to medical treatment received superior bulbar conjunctival resection, and another 20 patients who underwent cataract and retinal surgery served as a control group. The conjunctiva specimens from study and control patients were examined by hematoxylin and eosin staining and immunohistochemistry using antibodies against mast cell tryptase. Results: In all operated eyes, the clinical symptoms and signs, including irritation and redness and superior bulbar conjunctival hyperemia and superior tarsal conjunctival papillary hypertrophy, subsided significantly three months after the operation. Only three eyes had recurrence from the margin of conjunctival resection, and this was relieved after reoperation. Keratinized conjunctival epithelium, loss of goblet cells, and increased mast cell numbers (P < .05) were found in the SLK group. Conclusions: Our cases demonstrate that superior bulbar conjunctival resection combined with Tenon layer excision is an effective treatment for SLK. The pathologic findings suggest that mast cells may play a role in the pathogenesis of SLK. ? 2008 Elsevier Inc. All rights reserved.
SDGs
Other Subjects
eosin; hematoxylin; tryptase; article; cataract extraction; conjunctival hyperemia; controlled study; evaluation; eye irritation; eye surgery; goblet cell; human; human tissue; immunohistochemistry; keratoconjunctivitis; mast cell; priority journal; recurrent disease; reoperation; retina surgery; retrospective study; superior limbic keratoconjunctivitis; symptom; Taiwan; tenon layer excision
Type
journal article