IMPRESSION DEBRIDEMENT OF CORNEAL LESIONS

Purpose: The technique of impression cytology using cellulose acetate filter paper as a debriding agent was evaluated. Methods: Lesions were assessed using a slit-lamp biomicroscope before and after the impress ions were taken and appropriate antibiotic therapy was started. The fi lter, paper impressions were stained with hematoxylin-eosin and examin ed by light microscopy. The 72 corneal ulcers and three cases of sutur e infiltration around exposed corneoscleral cataract-related sutures w ere effectively debrided. Five of the six foreign bodies and all of th e filaments in the six filamentary keratitis cases were removed with m inimal damage to the surrounding cornea. Results: Results of microscop ic examination showed that the cells that were transferred to the filt er paper were primarily the affected cells. In corneal ulcers, the deg enerated epithelial cells, inflammatory cells, and organisms were remo ved. The inflammatory cells superimposed on affected epithelial cells in suture infiltration and the filaments of filamentary keratitis were removed. In cases of superficial corneal foreign bodies, the foreign bodies overlying a sheet of degenerated epithelial cells were lifted u p. Conclusion: ''impression debridement'' improves the quality and eff iciency of debridement for most of these conditions, with much less ri sk to the surrounding tissue than the conventional techniques. Besides being an adjunct to therapy, it simultaneously provides replicas of t he lesions that give accurate histologic details after microscopic eva luation.