Clinical and cytological findings in limbal stem cell deficiency

Abstract

This study confirmed the importance of cytological tests in the diagnosis of LSCD. Furthermore, the absence of goblet cells may not exclude corneal conjunctivalisation as demonstrated by cytokeratin 19 immunostaining. Lastly, corneal conjunctivalisation was associated with zone-specific impairment in corneal sensitivity.

Cytological features of live limbal tissue donor eyes for autograft or allograft limbal stem cell transplantation

“…LSCD can be confirmed by detection of goblet cells on the surface of the cornea by impression cytology (7) . Goblet cells can be easily highlighted by performing routine PAS staining on the specimens (3)(4)6) .…”

“…Goblet cells can be easily highlighted by performing routine PAS staining on the specimens (3)(4)6) . The identification of cytokeratins Legend: M= male; F= female; IC= impression cytology specific for corneal and conjunctival epithelium has been also proposed for the diagnosis of LSCD, especially if the disease induces an advanced squamous metaplasia with total loss of goblet cells on conjunctiva (5,7) . Limbal tissue has been generally dissected respecting the epithelial depth and the dissection can include tissue from the peripheral cornea and adjacent conjunctiva (8) .…”

“…Primary diseases (aniridia, iris coloboma and neurotrophic keratopathy) or secondary conditions (chemical and thermal injuries, Stevens-Johnson syndrome, ocular cicatricial pemphigoid, contact lens-related epitheliopathy, severe microbial keratitis and multiple surgical procedures at the limbal region) can lead to partial or total limbal stem cell deficiency (LSCD) (3) . In addition to the clinical findings, the demonstration by impression cytology (IC) of goblet cells in the corneal epithelium has been considered as an important diagnostic hallmark of LSCD (3)(4)(5)(6)(7) . The classical treatment for total LSCD is limbal stem cell transplantation.…”

Impression cytology and in vivo confocal microscopy in corneas with total limbal stem cell deficiency

“…Limbal stem cell deficiency (LSCD) is a clinical condition that occurs in a variety of ocular diseases, including ocular chemical injuries, Stevens Johnson syndrome and ocular cicatricial pemphigoid (4,5) . Ty pical LSCD symptoms are decreased vision, photophobia, tearing, burning and recurrent pain episodes (1,6) . The clinical picture is a conjunctivalized corneal surface with neovessels and recurrent or persistent epithelial defects (1,4,6) .…”

“…Ty pical LSCD symptoms are decreased vision, photophobia, tearing, burning and recurrent pain episodes (1,6) . The clinical picture is a conjunctivalized corneal surface with neovessels and recurrent or persistent epithelial defects (1,4,6) . Tests for LSCD should demonstrate the presence and the extension of the deficiency.…”