Similar to our results, in a study by Francis et al on 18 patients with CCh (29 biopsy specimens) and 24 controls (24 biopsy specimens), 22 of 29 specimens of CCh (76%) had normal conjunctiva, and only three of their specimens demonstrated stromal elastosis.[ 11 ] The spectrum of these contradictory changes may be due to the grade of disease severity, location of the conjunctival biopsy, or the degree of actinic damage.[ 15 ] On the other hand, although in our study lymphangiectasia was more common in the CCh group (70.1% versus 43.8%), the difference did not reach statistical significance [ Table 2 ].
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