Purpose To investigate the pathologic features of the relaxed conjunctiva of conjunctivochalasis (CCh). Methods One normal subject (female, with senile cataract) aged 74 years and 7 CCh patients (3 males and 4 females, aged 65-70 years) were included in this study. Light and electron microscopy were performed on the excised conjunctiva. Specific staining: Verhoeff for elastic fiber, Maasson trichrome for collagen fiber, AB-PAS for goblet cell; imunohistochemistry examinations were routinely performed with Vimentin staining for fibroblast. Results The conjunctival epithelium of CCh thinned with varying degrees of keratinizing; the elastic fibers decreased in number and collagen fibers were molten; the decreased number was seen with goblet cells while they were stained blue with AB and/or PAS dye; conjunctival fibrocytes were predominant in the conjunctival stroma of the CCh patients as the number of the fibroblasts decreased. On electron microscopy, no enlargement of rough endoplasmic reticular or few mitochondria was noted with the conjunctival fibroblast and the number of goblet cells decreased with irregular appearance. Conclusion Both the decreased number and declining metabolic function are found with the conjunctival fibroblasts of CCh and play a role in the pathogenesis of CCh; the decreased number of goblet cells is likely to lend to the complaints of dry eye in CCh patients. |