Department of Ophthalmology, Mackay Memorial Hospital, Taipei, Taiwan.
Department of Medicine, Mackay Medical College, Taipei, Taiwan; and.
Cornea. 2020 Jun;39(6):736-741. doi: 10.1097/ICO.0000000000002264.
To describe the efficacy of autologous serum (AS) eye drops to reverse severe contact lens (CL)-induced limbal stem cell (LSC) deficiency (LSCD).
This is a prospective, uncontrolled, interventional case series that enrolled 20 eyes of 14 consecutive patients diagnosed with severe CL-induced LSCD at presentation, based on clinical examination, at a tertiary referral center for the period December 2016 to December 2018. All eyes underwent AS treatment for at least 2 weeks with a follow-up for at least 2 months. Demographic data and treatment outcomes were collected and analyzed.
The mean patient age at presentation was 30.5 years (range, 19-49 years). The mean duration of soft contact lens wear was 15.6 years (SD, 7.58 years; range, 5-31 years). All study eyes had pain and blurred vision at presentation. All eyes had recurrent or persistent corneal epithelial defect, stromal scarring and opacity, and superficial vascularization and peripheral pannus at presentation. Aggressive treatment with AS succeeded in all eyes. Signs and symptoms of LSCD stabilized in all eyes within 2 weeks and resolved in 6 eyes (30.0%) in 2 weeks, 9 eyes (45.0%) in 4 weeks, and 5 eyes (25.0%) in 8 weeks. The mean follow-up time was 9.45 ± 1.79 weeks (range, 8-24 weeks).
Early identification and aggressive treatment of the ocular surface disease with AS can medically reverse severe CL-induced LSCD and prevent the need for surgical intervention.
描述自体血清（AS）滴眼剂逆转严重接触镜（CL）诱导的角膜缘干细胞（LSC）缺乏（LSCD）的疗效。
这是一项前瞻性、非对照、干预性病例系列研究，纳入了 2016 年 12 月至 2018 年 12 月在一家三级转诊中心就诊的 14 例连续患者的 20 只眼睛，这些患者均基于临床检查诊断为初次就诊时的严重 CL 诱导 LSCD。所有眼睛均接受 AS 治疗至少 2 周，并至少随访 2 个月。收集并分析了人口统计学数据和治疗结果。
患者就诊时的平均年龄为 30.5 岁（范围，19-49 岁）。软性隐形眼镜佩戴的平均时间为 15.6 年（SD，7.58 年；范围，5-31 年）。所有研究眼在就诊时均有疼痛和视力模糊。所有眼在就诊时均有复发性或持续性角膜上皮缺损、基质瘢痕和混浊，以及浅层血管化和周边血管翳。AS 的积极治疗在所有眼中均取得成功。所有眼睛的 LSCD 体征和症状在 2 周内稳定，6 只眼睛（30.0%）在 2 周内、9 只眼睛（45.0%）在 4 周内、5 只眼睛（25.0%）在 8 周内得到缓解。平均随访时间为 9.45±1.79 周（范围，8-24 周）。
早期识别和积极治疗 AS 的眼表疾病可以通过药物逆转严重的 CL 诱导的 LSCD，并防止需要手术干预。
