Conjunctival MUC5AC+ goblet cell index: relationship with corneal nerves and dry eye

摘要

Purpose To evaluate the relative proportion of conjunctival MUC5AC+ and MUC5AC? goblet cells in a post-LASIK population and their association with dry eye indicators and corneal nerve morphology using a MUC5AC+ Goblet Cell Index. Methods Twenty subjects who had undergone LASIK >?12?months previously and 20 age-matched controls were recruited. Dry eye symptoms, tear breakup time, osmolarity, meniscus area and corneal nerve morphology were examined. Conjunctival impression cytology samples were collected from inferior-temporal bulbar conjunctiva using Millicell? inserts. Total goblet cell density was determined from positive cytokeratin-7 (CK7) immunolabelling; MUC5AC+ goblet cell density was determined from both CK7+- and MUC5AC+-immunolabelled cells. The ratio of MUC5AC+ to total density was defined as the “MUC5AC+ Goblet Cell Index”. Differences in variables between groups and the associations between goblet cell variables and clinical assessments were examined. Results No significant differences in the total and MUC5AC+ goblet cell density and tear film parameters were found between groups, although greater ocular discomfort was reported in the post-LASIK group ( P ?=?0.02). A higher MUC5AC+ Index was associated with worse/greater dry eye symptoms ( ρ ?=?0.55, P ?=?0.01) and higher nerve tortuosity ( ρ ?=?0.57, P ?=?0.01) in the post-LASIK group; lower nerve density and thickness was found in controls ( ρ ?>??0.45, P ?