Long-Term Benefits of Tear Exchangeable Limbal-Rigid Contact Lens Wear Therapy in Stevens–Johnson Syndrome Cases

Abstract

Objectives: To evaluate the long-term benefits of tear-exchangeable, limbal-rigid contact lens (CL) wear therapy in patients with Stevens-Johnson syndrome (SJS)-associated ocular sequelae. Methods: This retrospective study evaluated 50 eyes of 41 SJS patients (15 men and 26 women) who underwent limbal-rigid CL wear therapy for more than 2 years post fitting. Ocular sequelae (i.e., conjunctival hyperemia, corneal neovascularization, and upper tarsus scarring) before fitting and at 3 months, 6 months, 12 months, and annually after initiating CL wear therapy were evaluated and then graded on a severity score (range: 0-3, maximum score: 3). Moreover, visual acuity (VA) at immediately post initiating CL wear therapy was evaluated. Results: The mean follow-up period was 4.361.1 years. Compared with before fitting, the mean conjunctival hyperemia score improved from 1.14 to 0.86 at 3 months of CL wear therapy (P,0.01) and was maintained thereafter; the mean corneal neovascularization score improved from 2.10 to 1.98 at 3 months of CL wear therapy, with no deterioration of the score observed in all cases at the final follow-up examination, and mean VA (log of minimum angle of resolution) improved from 1.60 to 1.04 at immediately post initiating CL wear therapy (P,0.01). Conclusions: Limbal-rigid CL wear therapy can provide long-term ocular surface stabilization and improved VA in SJS patients.

Strategic combination of cultivated oral mucosal epithelial transplantation and postoperative limbal-rigid contact lens-wear for end-stage ocular surface disease: a retrospective cohort study

“…16 The long-term follow-up (mean follow-up period: 4.3±1.1 years) of limbal-rigid CL therapy for SJS showed VA improvement. 17 Moreover, the effectiveness of our new limbalrigid CL when used as a therapeutic modality post COMET for the treatment of severe OSDs was evaluated, and we found that the use of the lens reduced corneal irregularity and improved visual function. In addition, the limbal-rigid CL was found to have good wettability when worn, thus reducing eye pain related to severe dryness of the ocular surface and providing long-term stabilisation of the ocular surface.…”

“…16 When a comparison was made between pre-CL fitting and 3 months after the initiation of the limbal-rigid CL-wear therapy, our findings revealed that conjunctival hyperaemia was decreased and that the reduction was maintained until the final follow-up examination performed at 5 years after the therapy was initiated. 17 Moreover, the design of the limbal-rigid CL in combination with proper and frequent use of artificial tears allowed each patient to wear the lens for more than 12 hours per day and avoid any pain associated with the extended usage. 6 21 Compared with at baseline, only a slight significant improvement in the condition of the OSGS corneal score was found at the final follow-up examination, and for unknown reasons, there was a slight reduction in corneal opacification.…”