Conjunctival impression cytology in pseudoexfoliative glaucoma and pseudoexfoliation syndrome

Abstract

In this study, ocular surface changes and tear film functions in patients with pseudoexfoliative glaucoma (PEXG) and pseudoexfoliation (PEX) syndrome were evaluated. This study is a randomized, double-blind and prospective study. Conjunctival impression cytology, tear film break-up time (TFBUT) test and basal Schirmer test (BST) were performed on 45 eyes of 45 subjects with PEXG (group I), 48 eyes of 48 subjects with PEX syndrome (group 2) and 50 eyes of 50 normal subjects (group 3). Impression cytology was graded 0-III based on the shape, eosinophilic-staining cytoplasm and nucleocytoplasmic ratio of the epithelial cells, and the shape, quantity and Periodic Acid Schiff-positive cytoplasm of the goblet cells. Impression cytology grading scores were 6.7% grade 0, 15.6% grade I, 37.7% grade II and 40% grade III in group 1, 6.3%, 18.7%, 43.8% and 31.2% in group 2 and 38%, 36.0%, 20% and 6% in group 3, respectively. The scores in groups 1 and 2 were significantly higher than in group 3 (P = 0.001, chi(2) = 39.84). The mean values of TFBUT of groups 1, 2 and 3 were 5.91 +/- 3.27, 7.39 +/- 4.82, 10.96 +/- 3.81 s and the mean values of BST were 7.82 +/- 3.56, 9.04 +/- 4.60 and 12.50 +/- 5.25 mm/5 min, respectively. The values of TFBUT and BST were lower in groups 1 and 2 than in group 3 (P = 0.001). The conjunctival changes in PEX and PEXG patients recorded in this study may explain the existence of tear film abnormalities in these patients. It has been shown that PEXG and PEX syndrome cause conjunctival surface changes and reduction of tear film functions.