Impression Cytology Study of Epithelial Phenotype of Ocular Surface Reconstructed by Preserved Human Amniotic Membrane

doi:10.1001/archopht.1997.01100160530001

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Vol. 115 No. 11, November 1997

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Impression Cytology Study of Epithelial Phenotype of Ocular Surface Reconstructed by Preserved Human Amniotic Membrane

Pinnita Prabhasawat, MD; Scheffer C. G. Tseng, MD, PhD

Arch Ophthalmol. 1997;115(11):1360-1367.

Abstract

Objective
To determine the epithelial phenotype of the ocular surfacereconstructed by preserved human amniotic membrane.

Methods
Impression cytology was performed in 6 patients who receiveda large patch of amniotic membrane for conjunctival surfacereconstruction during removal of acquired melanosis, conjunctivalintraepithelial neoplasia, or bilateral inferior conjunctivalchalasis, or for corneal surface reconstruction during removalof pannus associated with limbal deficiency caused by aniridia,toxic epidermal necrolysis, or chemical burn.

Results
The nongoblet epithelial cells covering the amniotic membranewere uniformly smaller and the cell density was almost twicethat of age- and sex-matched normal control eyes at the correspondingsite, and the goblet cell density was almost 10 times that ofthe control (both P<.05; Student paired t test) (N=7 eyes).Furthermore, the conjunctival epithelial phenotype with gobletcells was found on corneal surfaces of all 3 patients with limbaldeficiency.

Conclusions
The success of conjunctival surface reconstruction correlatedwell with recovery of the conjunctival epithelial phenotype.The lack of corneal epithelial phenotype even on an avascularcorneal stroma supports the concept that conjunctival transdifferentiationdoes not occur in vivo, and indicates that additional limbalstem cell transplantation is needed for effective corneal surfacereconstruction in patients with limbal deficiency.

Author Affiliations

From the Ocular Surface and Tear Center, Department of Ophthalmology, Bascom Palmer Eye Institute (Drs Prabhasawat and Tseng), and Department of Cell Biology and Anatomy, University of Miami School of Medicine (Dr Tseng), Miami, Fla.

Footnotes

The authors do not have any proprietary interest in the productsmentioned.

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