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Sclero‐corneal lenses’ supply for the treatment of keratoconjunctivitis sicca in patients with refractory ocular GvHD
Author(s) -
RICHET M,
MAGRO L,
RANDON T,
ERNOULD F,
YAKOUBAGHA I,
LABALETTE P
Publication year - 2014
Publication title -
acta ophthalmologica
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.534
H-Index - 87
eISSN - 1755-3768
pISSN - 1755-375X
DOI - 10.1111/j.1755-3768.2014.s043.x
Subject(s) - medicine , keratoconjunctivitis sicca , refractory (planetary science) , ophthalmology , visual acuity , scleral lens , dermatology , artificial tears , vernal keratoconjunctivitis , cornea , physics , astrobiology
Purpose Keratoconjunctivitis sicca (KCS) due to chronic GvHD (cGvHD) is responsible for major alteration in quality of life of patients undergoing allogeneic stem cell transplantation . The conjunctival fibrosis induce impaired corneal and conjunctival epithelial surfaces. Treatment of KCS remains disappointing; variable success has been obtained with variety of topical treatments. Sclero‐corneal lenses bring a valid therapeutic option by creating a pre‐corneal reservoir of tears. Methods We describe the safety and efficacy of Sclero‐corneal lenses in a retrospective analysis of 7 patients with KCS due to cGvHD. All patients had superficial punctate keratitis refractory to standard treatments. Evaluation of patients was carried out by the same ophthalmologist and hematologist. OSDI score was used to evaluate ocular symptoms and Oxford score to quantify corneal damage. Visual acuity "LOG MAR" was used for comparative purposes of the study. Results All patients but one agreed to hold the lenses. The 12 eyes of the 6 remaining patients were equipped with lenses type ICD (LCS Company). All patients experienced an improvement in their quality of life with a clear improvement of dry‐eye symptoms. We observed 100% improvement in OSDI score with an average improvement of 67.08 points, 100% improvement or stability of visual acuity with an average gain of ‐0.23 LOG MAR acuity and 100% improvement or stability of the Oxford score with a mean gain of 1,917 points. Conclusion Despite its limited size, this cohort of patients treated with sclero‐corneal lenses is promising. Whenever possible, this approach should be considered in patients experiencing KCS refractory to standard treatments in cGVHD.