Long-term effect of corneoscleral contact lenses on refractory ocular surface diseases

Sang Mok Lee, Yu Jeong Kim, Se Hyun Choi, Joo Youn Oh, Mee Kum Kim

Research output: Contribution to journalArticleResearchpeer-review

Abstract

Purpose: To report the therapeutic effect of corneoscleral contact lenses (CLs) with a diameter of 14.0 mm on the refractory ocular surface diseases. Methods: Medical records of 13 eyes (of nine patients) attempted for fitting with corneoscleral CLs for the management of the severe refractory ocular surface diseases were retrospectively reviewed including Stevens-Johnson syndrome (SJS; eight eyes) and chronic ocular graft-versus-host disease (GVHD; five eyes). Lenses were fitted to improve refractory punctate epithelial erosions (PEE, ten eyes) and persistent epithelial defect (PED, three eyes with SJS) despite the proper medical management. Short-term (1 month) and long-term (12 months) changes in the best corrected visual acuity (BCVA), corneal fluorescein staining (CFS) score, mean wearing time, and National Eye Institute's Visual Function Questionnaire-25 (VFQ-25) were evaluated. Results: Of the 13 eyes, ten eyes were successfully fitted with the corneoscleral CLs. The fitting was failed in three eyes due to small palpebral fissure and shortened fornices (two eyes) and handling difficulty (one eye). At one-month follow-up after successful fitting in ten eyes, mean wearing time was 12.6 h (6.5–17, all day long) and BCVA improved from 0.56 ± 0.59 to 0.27 ± 0.46 in logMAR (P = .018). For the eight well-fitted eyes with refractory PEE, CFS score improved from 7.38±2.20 to 5.13±2.48 (P = .024). PED improved in all two eyes which were successfully fitted with corneoscleral CLs (Of the three eyes with PED, one eye failed fitting). At 12-month follow-up, mean wearing time was 11.4 h and the improved BCVA and CFS score were maintained. Furthermore, no adverse events attributable to corneoscleral CLs use occurred. Conclusion: The corneoscleral CLs with a diameter of 14.0 mm were successfully fitted in ten out of 13 eyes with severe refractory ocular surface diseases and demonstrated therapeutic benefits in the well-fitted eyes. The corneoscleral CL can be an option in the management of severe refractory ocular surface diseases.

Original languageEnglish
Pages (from-to)399-405
Number of pages7
JournalContact Lens and Anterior Eye
Volume42
Issue number4
DOIs
StatePublished - 1 Aug 2019

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Eye Diseases
Contact Lenses
Fluorescein
Visual Acuity
Staining and Labeling
National Eye Institute (U.S.)
Stevens-Johnson Syndrome
Therapeutic Uses
Graft vs Host Disease
Eyelids

Keywords

  • Contact lens
  • Corneoscleral
  • Epitheliopathy
  • Graft-versus-host disease
  • Stevens-Johnson syndrome

Cite this

@article{c6bfa588e77043309f0a66a1298d31d7,
title = "Long-term effect of corneoscleral contact lenses on refractory ocular surface diseases",
abstract = "Purpose: To report the therapeutic effect of corneoscleral contact lenses (CLs) with a diameter of 14.0 mm on the refractory ocular surface diseases. Methods: Medical records of 13 eyes (of nine patients) attempted for fitting with corneoscleral CLs for the management of the severe refractory ocular surface diseases were retrospectively reviewed including Stevens-Johnson syndrome (SJS; eight eyes) and chronic ocular graft-versus-host disease (GVHD; five eyes). Lenses were fitted to improve refractory punctate epithelial erosions (PEE, ten eyes) and persistent epithelial defect (PED, three eyes with SJS) despite the proper medical management. Short-term (1 month) and long-term (12 months) changes in the best corrected visual acuity (BCVA), corneal fluorescein staining (CFS) score, mean wearing time, and National Eye Institute's Visual Function Questionnaire-25 (VFQ-25) were evaluated. Results: Of the 13 eyes, ten eyes were successfully fitted with the corneoscleral CLs. The fitting was failed in three eyes due to small palpebral fissure and shortened fornices (two eyes) and handling difficulty (one eye). At one-month follow-up after successful fitting in ten eyes, mean wearing time was 12.6 h (6.5–17, all day long) and BCVA improved from 0.56 ± 0.59 to 0.27 ± 0.46 in logMAR (P = .018). For the eight well-fitted eyes with refractory PEE, CFS score improved from 7.38±2.20 to 5.13±2.48 (P = .024). PED improved in all two eyes which were successfully fitted with corneoscleral CLs (Of the three eyes with PED, one eye failed fitting). At 12-month follow-up, mean wearing time was 11.4 h and the improved BCVA and CFS score were maintained. Furthermore, no adverse events attributable to corneoscleral CLs use occurred. Conclusion: The corneoscleral CLs with a diameter of 14.0 mm were successfully fitted in ten out of 13 eyes with severe refractory ocular surface diseases and demonstrated therapeutic benefits in the well-fitted eyes. The corneoscleral CL can be an option in the management of severe refractory ocular surface diseases.",
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Long-term effect of corneoscleral contact lenses on refractory ocular surface diseases. / Lee, Sang Mok; Kim, Yu Jeong; Choi, Se Hyun; Oh, Joo Youn; Kim, Mee Kum.

In: Contact Lens and Anterior Eye, Vol. 42, No. 4, 01.08.2019, p. 399-405.

Research output: Contribution to journalArticleResearchpeer-review

TY - JOUR

T1 - Long-term effect of corneoscleral contact lenses on refractory ocular surface diseases

AU - Lee, Sang Mok

AU - Kim, Yu Jeong

AU - Choi, Se Hyun

AU - Oh, Joo Youn

AU - Kim, Mee Kum

PY - 2019/8/1

Y1 - 2019/8/1

N2 - Purpose: To report the therapeutic effect of corneoscleral contact lenses (CLs) with a diameter of 14.0 mm on the refractory ocular surface diseases. Methods: Medical records of 13 eyes (of nine patients) attempted for fitting with corneoscleral CLs for the management of the severe refractory ocular surface diseases were retrospectively reviewed including Stevens-Johnson syndrome (SJS; eight eyes) and chronic ocular graft-versus-host disease (GVHD; five eyes). Lenses were fitted to improve refractory punctate epithelial erosions (PEE, ten eyes) and persistent epithelial defect (PED, three eyes with SJS) despite the proper medical management. Short-term (1 month) and long-term (12 months) changes in the best corrected visual acuity (BCVA), corneal fluorescein staining (CFS) score, mean wearing time, and National Eye Institute's Visual Function Questionnaire-25 (VFQ-25) were evaluated. Results: Of the 13 eyes, ten eyes were successfully fitted with the corneoscleral CLs. The fitting was failed in three eyes due to small palpebral fissure and shortened fornices (two eyes) and handling difficulty (one eye). At one-month follow-up after successful fitting in ten eyes, mean wearing time was 12.6 h (6.5–17, all day long) and BCVA improved from 0.56 ± 0.59 to 0.27 ± 0.46 in logMAR (P = .018). For the eight well-fitted eyes with refractory PEE, CFS score improved from 7.38±2.20 to 5.13±2.48 (P = .024). PED improved in all two eyes which were successfully fitted with corneoscleral CLs (Of the three eyes with PED, one eye failed fitting). At 12-month follow-up, mean wearing time was 11.4 h and the improved BCVA and CFS score were maintained. Furthermore, no adverse events attributable to corneoscleral CLs use occurred. Conclusion: The corneoscleral CLs with a diameter of 14.0 mm were successfully fitted in ten out of 13 eyes with severe refractory ocular surface diseases and demonstrated therapeutic benefits in the well-fitted eyes. The corneoscleral CL can be an option in the management of severe refractory ocular surface diseases.

AB - Purpose: To report the therapeutic effect of corneoscleral contact lenses (CLs) with a diameter of 14.0 mm on the refractory ocular surface diseases. Methods: Medical records of 13 eyes (of nine patients) attempted for fitting with corneoscleral CLs for the management of the severe refractory ocular surface diseases were retrospectively reviewed including Stevens-Johnson syndrome (SJS; eight eyes) and chronic ocular graft-versus-host disease (GVHD; five eyes). Lenses were fitted to improve refractory punctate epithelial erosions (PEE, ten eyes) and persistent epithelial defect (PED, three eyes with SJS) despite the proper medical management. Short-term (1 month) and long-term (12 months) changes in the best corrected visual acuity (BCVA), corneal fluorescein staining (CFS) score, mean wearing time, and National Eye Institute's Visual Function Questionnaire-25 (VFQ-25) were evaluated. Results: Of the 13 eyes, ten eyes were successfully fitted with the corneoscleral CLs. The fitting was failed in three eyes due to small palpebral fissure and shortened fornices (two eyes) and handling difficulty (one eye). At one-month follow-up after successful fitting in ten eyes, mean wearing time was 12.6 h (6.5–17, all day long) and BCVA improved from 0.56 ± 0.59 to 0.27 ± 0.46 in logMAR (P = .018). For the eight well-fitted eyes with refractory PEE, CFS score improved from 7.38±2.20 to 5.13±2.48 (P = .024). PED improved in all two eyes which were successfully fitted with corneoscleral CLs (Of the three eyes with PED, one eye failed fitting). At 12-month follow-up, mean wearing time was 11.4 h and the improved BCVA and CFS score were maintained. Furthermore, no adverse events attributable to corneoscleral CLs use occurred. Conclusion: The corneoscleral CLs with a diameter of 14.0 mm were successfully fitted in ten out of 13 eyes with severe refractory ocular surface diseases and demonstrated therapeutic benefits in the well-fitted eyes. The corneoscleral CL can be an option in the management of severe refractory ocular surface diseases.

KW - Contact lens

KW - Corneoscleral

KW - Epitheliopathy

KW - Graft-versus-host disease

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