Aragona P, Ferreri G, Micali A, Puzzolo D
Institute of Ophthalmology, University of Messina, Italy.
Eye (Lond). 1998;12 ( Pt 3a):461-6. doi: 10.1038/eye.1998.105.
Conjunctival changes induced by rigid, gas-permeable and soft contact lenses (CL) were investigated using impression cytology. A scoring system based on seven parameters (specimen cellularity, cell-to-cell contacts, nucleus/cytoplasm ratio, chromatin, goblet cell distribution, keratinisation, inflammatory cells) was used to evaluate the morphological results.
One hundred and seventy-two CL-wearing eyes and 40 control eyes were examined. The population was divided into three groups: group 1, control eyes; group 2, asymptomatic CL-wearing eyes; group 3, CL-wearing eyes with intolerance problems. Impression cytology was carried out and all specimens were evaluated according to a scoring system.
Group 1 specimens always showed normal features in the conjunctival epithelium. In group 2, rigid and gaspermeable lenses produced greater changes in conjunctival morphology than soft lenses, especially as regards cellularity, nucleus/cytoplasm ratio, goblet cell distribution and total score. On the contrary, in group 3 wearers of soft lenses showed higher partial and total scores than wearers of gas-permeable and rigid lenses.
In asymptomatic CL wearers conjunctival morphology was better preserved in wearers of soft lenses. In patients with intolerance problems, wearers of soft lenses showed the worst cytological features. Impression cytology, evaluated with this scoring system, can be used to demonstrate epithelial damage occurring in CL-wearing patients.
采用印迹细胞学方法研究硬性透气性隐形眼镜（CL）和软性隐形眼镜引起的结膜变化。使用基于七个参数（标本细胞性、细胞间接触、核质比、染色质、杯状细胞分布、角化、炎症细胞）的评分系统来评估形态学结果。
对172只佩戴隐形眼镜的眼睛和40只对照眼进行检查。研究对象分为三组：第1组，对照眼；第2组，无症状佩戴隐形眼镜的眼睛；第3组，佩戴隐形眼镜有不耐受问题的眼睛。进行印迹细胞学检查，并根据评分系统对所有标本进行评估。
第1组标本的结膜上皮始终呈现正常特征。在第2组中，硬性和透气性隐形眼镜比软性隐形眼镜引起的结膜形态变化更大，尤其是在细胞性、核质比、杯状细胞分布和总分方面。相反，在第3组中，软性隐形眼镜佩戴者的部分评分和总分高于透气性和硬性隐形眼镜佩戴者。
在无症状的隐形眼镜佩戴者中，软性隐形眼镜佩戴者的结膜形态保存较好。在有不耐受问题的患者中，软性隐形眼镜佩戴者的细胞学特征最差。用该评分系统评估的印迹细胞学可用于证明佩戴隐形眼镜患者发生的上皮损伤。
