TEMPORARY CORNEAL STEM-CELL DYSFUNCTION AFTER RADIATION-THERAPY

Background-Radiation therapy can cause corneal and conjunctival abnorm alities that sometimes require surgical treatment. Corneal stem cell d ysfunction is described, which recovered after the cessation of radiat ion. Methods-A 44-year-old man developed a corneal epithelial abnormal ity associated with conjunctival and corneal inflammation following ra diation therapy for maxillary cancer. He experienced ocular pain and l oss of vision followed by conjunctival epithelialisation of the upper and lower parts of the cornea. Results-Examination of brush cytology s amples showed goblet cells in the upper and lower parts of the cornea, which showed increased fluorescein permeability, and intraepithelial lymphocytes. Impression cytology showed goblet cells in the same part of the cornea. Specular microscopy revealed spindle type epithelial ce lls. Patient follow up included artificial tears and an antibiotic oph thalmic ointment. The corneal abnormalities resolved after 4 months wi th improved visual acuity without any surgical intervention, but the d isappearance of the palisades of Vogt did not recover at 1 year after radiation. Conclusion-Radiation therapy in this patient caused tempora ry stem cell dysfunction which resulted in conjunctivalisation in a pa rt of the cornea. Although limbal stem cell function did not fully rec over, this rare case suggested that medical options should be consider ed before surgery.