Aims

To evaluate the clinical and visual outcomes of fluid-filled scleral lens devices (SL) wear in patients with limbal stem cell deficiency (LSCD).

Design

Retrospective consecutive case series.

Methods

27 eyes with LSCD confirmed by in vivo confocal microscopy at the Stein Eye Institute and fitted with SL were included. Correlations between corrected distance visual acuity (CDVA) and LSCD stage determined by clinical grading were performed between baseline (after the SL fit) and the last follow-up (the time of discontinuation of SL wear or the last visit in eyes in which SL were continued). In a subset of patients that had worsened LSCD while using SL, anterior segment optical coherence tomography (AS-OCT) and anterior segment fluorescein angiogram (AS-FA) were performed.

Results

Baseline LSCD grading was stage I in 12 eyes (44.4%), stage 2 in 12 eyes (44.4%), and stage III in 3 eyes (11.1%). At the last follow-up, CDVA was improved in 7 eyes (25.9%), remained stable in 13 eyes (48.1%) and decreased in 7 eyes (25.9%, P = 0.16). The LSCD stage was improved in 7 eyes (25.9%), remained stable in 8 eyes (29.6%) and worsened in 12 eyes (44.4%, P = 0.10). AS-OCT and AS-FA, performed in 5 eyes, showed limbal compression and delayed fluorescein filling.

Conclusion

SL can improve visual acuity and maintain the ocular surface in the majority of eyes. Worsening of the ocular surface might be a result of limbal hypoxia. Close monitoring of SL fit is necessary in these compromised eyes.

中文翻译：

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充满液体的巩膜晶状体装置治疗角膜缘干细胞缺乏症的临床结果和并发症

宗旨

评估角膜缘干细胞缺乏症 (LSCD) 患者佩戴充液巩膜片装置 (SL) 的临床和视力结果。

设计

回顾性连续病例系列。

方法

包括 27 只在 Stein Eye Institute 通过体内共聚焦显微镜确认并配备 SL 的 LSCD 眼。在基线（佩戴 SL 后）和最后一次随访（停止佩戴 SL 的时间或佩戴 SL 的眼睛的最后一次就诊时间）之间进行校正远视力 (CDVA) 和由临床分级确定的 LSCD 分期之间的相关性继续）。在使用 SL 时 LSCD 恶化的一部分患者中，进行了眼前节光学相干断层扫描 (AS-OCT) 和眼前节荧光素血管造影 (AS-FA)。

结果

基线 LSCD 分级为 I 期 12 只眼 (44.4%)、2 期 12 只眼 (44.4%) 和 III 期 3 只眼 (11.1%)。末次随访CDVA改善7眼（25.9%），稳定13眼（48.1%），下降7眼（25.9%，P=0.16 ）  。LSCD分期改善7只眼（25.9%），稳定8只眼（29.6%），恶化12只眼（44.4%，P  =0.10）。在 5 只眼中进行的 AS-OCT 和 AS-FA 显示角膜缘受压和荧光素充盈延迟。

结论

SL 可以提高视力并保持大多数眼睛的眼表。眼表的恶化可能是角膜缘缺氧的结果。在这些受损的眼睛中，必须密切监测 SL 适配度。