Description of squamous metaplasia by citology of impression in patients with dry eye

Abstract

Dry eye is characterized by a deficiency in the quantity or quality of the lachrymal film, which implies histological changes in the surface of the eye such as squamous metaplasia. The purpose was to determine the degree of the squamous metaplasia in the conjunctiva surface in patients with dry eye with different degrees of clinical severity. <em><strong>Methods:</strong></em> 63 eyes diagnosed with light, moderate and severe dry eye and 20 eyes like controls subject were made impression cytology in the temporal and nasal bulbar conjunctiva with membranes of biopore (Millipore PICM012550). Membranes were fixed with ethanol at 96% and colored with periodic acid of Shiffhematoxylin, and they were mounted between slide and small slide with Entellan. The degree of squamous metaplasia was determined regarding the number of goblet cells and the morphologic changes of epithelial cells, using the Murube and Rivas grading. <em><strong>Results:</strong></em> approximately half of the patients with light dry eye (49%) presented a degree 1 of squamous metaplasia, 53.8% of the patients with moderate dry eye presented a degree 2 and the 57.1% of the patients with severe dry eye presented a degree 3. Conclusions: the degree of squamous metaplasia by cytology of impression is easily evidenced in patients with moderate and severe dry eye, which contributes to the configuration of the clinical diagnosis and the follow up of the disease.