IMPRESSION CYTOLOGY STUDY OF EPITHELIAL PHENOTYPE OF OCULAR SURFACE RECONSTRUCTED BY PRESERVED HUMAN AMNIOTIC MEMBRANE

Objective: To determine the epithelial phenotype of the ocular surface reconstructed by preserved human amniotic membrane. Methods: Impressi on cytology was performed in 6 patients who received a large patch of amniotic membrane for conjunctival surface reconstruction during remov al of acquired melanosis, conjunctival intraepithelial neoplasia, or b ilateral inferior conjunctival chalasis, or for corneal surface recons truction during removal of pannus associated with limbal deficiency ca used by aniridia, toxic epidermal necrolysis, or chemical burn. Result s: The nongoblet epithelial cells covering the amniotic membrane were uniformly smaller and the cell density was almost twice that of age-an d sex-matched normal control eyes at tile corresponding site, and the goblet cell density was almost 10 times that of the control (both P<.0 5; Student paired t test) (N=7 eyes). Furthermore, the conjunctival ep ithelial phenotype with goblet cells vr as found on corneal surfaces o f all 3 patients with limbal deficiency. Conclusions: The success of c onjunctival surface reconstruction correlated well with recovery of th e conjunctival epithelial phenotype. The lack of corneal epithelial ph enotype even on an avascular corneal stroma supports the concept that conjunctival transdifferentiation does not occur in vivo, and indicate s that additional limbal stem cell transplantation is needed for effec tive corneal surface reconstruction in patients with limbal deficiency .