Weber Sarah La Porta, Hazarbassanov Rossen Mihaylov, Nasaré Alex, Gomes José Álvaro Pereira, Hofling-Lima Ana Luisa
Department of Ophthalmology, Ocular Surface Advanced Center, Federal University of Sao Paulo, 821 Botucatu St-Vila Clementino, Sao Paulo, SP, 04023-062, Brazil.
Department of Ophthalmology, Ocular Surface Advanced Center, Federal University of Sao Paulo, 821 Botucatu St-Vila Clementino, Sao Paulo, SP, 04023-062, Brazil.
Cont Lens Anterior Eye. 2017 Jun;40(3):151-156. doi: 10.1016/j.clae.2016.12.008. Epub 2017 Jan 6.
To evaluate conjunctival impression cytology and HLADR expression changes after wearing scleral contact lenses (ScCLs) for moderate to severe dry eye disease (DED).
Prospective interventional case series.
Forty-one eyes from 25 patients with moderate to severe DED were evaluated for Esclera ScCL treatment. Best-corrected visual acuity (BCVA) and slit-lamp findings were assessed. Impression cytology specimens were obtained from DED patients at the baseline and after wearing ScCLs for 12 months. The impression cytology specimens were analyzed using morphological results score, and HLA-DR positive cells were detected and quantified. The values were compared to assess the IC changes after wearing ScCLs.
Forty-one eyes from 25 patients were fitted with ScCLs to manage DED. The underlying diseases were Stevens-Johnson syndrome (22 eyes), Sjogren's syndrome (11 eyes), graft-versus-host disease (2 eyes), dry eye after keratomileusis (2 eyes) and undifferentiated ocular surface disease (4 eyes). The HE-PAS impression cytology score did not differ significantly before and after wearing ScCLs for 12 months in DED patients (p>0.05). The percentage of eyes expressing the HLA-DR antigen in the temporal conjunctiva after wearing ScCL for 12 months significantly increased in patients with Sjogren's syndrome (11.11% to 66.66%; p=0.0498). In groups with Stevens Johnson syndrome and other ocular surface disorders, we did not observe statistically significant differences (p>0.05).
The ScCLs did not change the parameters used to evaluate inflammatory processes, which were measured using conjunctival impression cytology and HLA-DR expression, except in Sjogren syndrome, in which there was an unexpected increase in HLA expression.
评估中重度干眼患者佩戴巩膜接触镜（ScCLs）后结膜印迹细胞学及人类白细胞抗原DR（HLADR）表达的变化。
前瞻性干预病例系列研究。
对25例中重度干眼患者的41只眼进行Esclera ScCL治疗评估。评估最佳矫正视力（BCVA）和裂隙灯检查结果。在基线期及佩戴ScCLs 12个月后，从干眼患者获取印迹细胞学标本。采用形态学结果评分法分析印迹细胞学标本，并检测和定量HLA-DR阳性细胞。比较这些值以评估佩戴ScCLs后的印迹细胞学变化。
25例患者的41只眼佩戴ScCLs治疗干眼。潜在疾病包括史蒂文斯-约翰逊综合征（22只眼）、干燥综合征（11只眼）、移植物抗宿主病（2只眼）、角膜磨镶术后干眼（2只眼）和未分化眼表疾病（4只眼）。干眼患者佩戴ScCLs 12个月前后，苏木精-伊红-过碘酸雪夫（HE-PAS）印迹细胞学评分差异无统计学意义（p>0.05）。干燥综合征患者佩戴ScCL 12个月后，颞侧结膜表达HLA-DR抗原的眼的百分比显著增加（从11.11%增至66.66%；p=0.0498）。在史蒂文斯-约翰逊综合征组和其他眼表疾病组中，未观察到统计学显著差异（p>0.05）。
除干燥综合征中HLA表达意外增加外，ScCLs未改变用于评估炎症过程的参数，这些参数通过结膜印迹细胞学和HLA-DR表达进行测量。
