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December 1984

Mucous Membrane Grafting for Severe Palpebral Vernal Conjunctivitis

Arch Ophthalmol. 1984;102(12):1746-1748. doi:10.1001/archopht.1984.01040031412004

To the Editor.  —In the December 1983 issue of the Archives, Tse et al1 reported their success in treating four patients with severe palpebral vernal conjunctivitis and one with giant papillary conjunctivitis by conjunctival incision and mucous membrane grafting. The authors claimed that by totally excising the cobblestone papillae from the tarsal conjunctiva and grafting a replacement mucous membrane, they could improve patients' symptoms and prevent corneal changes by eliminating the mechanical action of the cobblestones.Our current understanding of pathophysiologic factors and their effects on the ocular surface in vernal conjunctivitis leads us to question the importance of the mechanical relationship between giant papillae and the corneal changes in this disease.Henriquez et al2 reported the increase in degranulated mast cell populations in the conjunctiva of patients with vernal conjunctivitis. We have shown that the level of histamine, one of the most important mast cell products, is