Background:Tear secretion and tear film stability seem to be influenced by pseudoexfoliation syndrome (PEX).Histopathological evaluation of conjunctival goblet cells in PEX patients might explain the influ ence on tea...Background:Tear secretion and tear film stability seem to be influenced by pseudoexfoliation syndrome (PEX).Histopathological evaluation of conjunctival goblet cells in PEX patients might explain the influ ence on tear film sta-bility.Methods:In a prospective,c ross-sectional study,40eyes of 40patients with PEX(study group)had mea-surement of Schirmer test with anesthesia and break-up time prior to cataract surgery.At th e end of an uneventful operation,a 1×1.5mm sample of conju nctival tissue was obtained and light and electron microscopy were per-formed.Results were compared with a control group.Histology evaluation was masked.Pr imary outcome mea-sures included Schirmer test with an esthesia,break-up time,goblet cell density and morphological character of conjunctiva and conjunctival goble t cells.Results:Both Schirmer test and break-up time valu es were significantly lower(P=0.01and P=0.001)in the PEX patients(mean 10.6mm and 8.6s respectively)than in the control group(13.4mm and 12.3s respectively).The number of goblet cells in patients wi th PEX compared with the control group showed no statisti cally significant differ-ence(P=0.66).Use of trichrome stain revealed sig nif-icant differences in the staining pr operties of goblet cells between patients with PEX and contro ls.On electron mi-croscopy,typical pseudoexfoliati on filaments were found in the connective tissue of conjunctiv a of PEX patients.Re-markable changes of mucin pockets in the study group were also noticed;they had extremely irregular distribu-tion,various forms of size and appearance and even com-plete collapse.Conclusion:Pseudoexfoliation seems to alter basic features of goblet cell morphology,thus af-fecting tear film stability.Further studies are necessary to determine the exact mechanism.展开更多
文摘Background:Tear secretion and tear film stability seem to be influenced by pseudoexfoliation syndrome (PEX).Histopathological evaluation of conjunctival goblet cells in PEX patients might explain the influ ence on tear film sta-bility.Methods:In a prospective,c ross-sectional study,40eyes of 40patients with PEX(study group)had mea-surement of Schirmer test with anesthesia and break-up time prior to cataract surgery.At th e end of an uneventful operation,a 1×1.5mm sample of conju nctival tissue was obtained and light and electron microscopy were per-formed.Results were compared with a control group.Histology evaluation was masked.Pr imary outcome mea-sures included Schirmer test with an esthesia,break-up time,goblet cell density and morphological character of conjunctiva and conjunctival goble t cells.Results:Both Schirmer test and break-up time valu es were significantly lower(P=0.01and P=0.001)in the PEX patients(mean 10.6mm and 8.6s respectively)than in the control group(13.4mm and 12.3s respectively).The number of goblet cells in patients wi th PEX compared with the control group showed no statisti cally significant differ-ence(P=0.66).Use of trichrome stain revealed sig nif-icant differences in the staining pr operties of goblet cells between patients with PEX and contro ls.On electron mi-croscopy,typical pseudoexfoliati on filaments were found in the connective tissue of conjunctiv a of PEX patients.Re-markable changes of mucin pockets in the study group were also noticed;they had extremely irregular distribu-tion,various forms of size and appearance and even com-plete collapse.Conclusion:Pseudoexfoliation seems to alter basic features of goblet cell morphology,thus af-fecting tear film stability.Further studies are necessary to determine the exact mechanism.
