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KMID : 0213520190330060500
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Korean Journal of Ophthalmology
2019 Volume.33 No. 6 p.500 ~ p.505
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Contact Lens Induced Limbal Stem Cell Deficiency: Clinical Features in Korean Patients
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Lee Seung-Chan
Hyon Joon-Young
Jeon Hyun-Sun
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Abstract
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Purpose: To describe the clinical features of Korean patients with contact lens-induced limbal stem cell deficiency (CL-LSCD).
Methods: Medical records of 22 patients who were diagnosed with CL-LSCD between 2014 and 2019 were reviewed retrospectively. Outcome measures included demographics, clinical presentation, treatment, clinical course, and pattern of contact lens (CL) wear.
Results: Forty-two eyes of 22 patients were found to have typical changes associated with CL-LSCD. Twenty (91%) patients were women and mean age was 36 ± 12 years. All patients had myopia with mean spherical equivalent of ?7.52 ± 3.2 diopter. Twenty (91%) patients had bilateral disease and the location of limbal involvement was diffuse in 20 eyes (47.6%) and partial in 22 eyes (52.4%, superior in 20 eyes and inferior in 2 eyes). Fourteen (63.6%) patients complained of decreased visual acuity. Average period of CL wear was 14 ± 9 years. Four patients used cosmetic colored CLs and four patients had a history of overnight CL wear. All 12 patients who completed follow-up (28 ± 42 weeks) showed improvement in visual acuity and ocular surface condition after cessation of CL wear and medical treatment. Of them, five (42%) patients showed full recovery while seven (58%) showed partial recovery.
Conclusions: If a patient with a history of CL wear for an extended period of time presents with decreased visual acuity, practitioners should perform detailed examinations with suspicion of CL-LSCD, including fluorescein staining. CL-LSCD is usually reversible and close follow-up with conservative treatment is recommended as the initial treatment option.
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KEYWORD
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Complications, Hydrophilic contact lenses, Limbal stem cell deficiency
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