Nakakura Shunsuke, Maruoka Sachiko, Chikama Taiichiro, Nagata Yuki, Terao Etsuko, Ueda Kanae, Dote Saki, Oogi Satomi
Department of Ophthalmology, Saneikai Tsukazaki Hospital, Himeji, Japan.
Ikuno Eye Clinic, Osaka, Japan.
Front Med (Lausanne). 2023 Jul 6;10:1161568. doi: 10.3389/fmed.2023.1161568. eCollection 2023.
Limbal epithelial stem cell deficiency (LSCD) is an abnormal corneal epithelial lesion with several causes. The patient was diagnosed using fluorescein staining. Bullous keratopathy, multiple surgeries, and drug-related damage can cause LSCD in glaucoma patients. We evaluated the medical treatment course for LSCD in patients with glaucoma. We retrospectively reviewed the electronic medical records of patients diagnosed with LSCD and investigated their background, course of treatment, and classification stages of LSCD before and after treatment. The global consensus classification system (stages IA-C, IIA-B, and III) proposed by Deng et al. (Cornea 2020) was used. Seven patients (two males) and eight eyes were studied. The median age of the patients was 82 years, and the mean duration of glaucoma treatment was 8 years. The patients had open-angle glaucoma (four eyes), exfoliation glaucoma (one eye), neovascular glaucoma (one eye), normal tension glaucoma (one eye), and uveitic glaucoma (one eye). Stage classifications at diagnosis were stage IA in four eyes and stages IC, IIA, IIB, and III in one eye each. All treatments were carried out with dry eye drops, steroid eye drops, and antibiotics. The mean duration of treatment was 1.4 years. The classifications at the time of the final visit were normal corneal epithelium (three eyes), stage IA (two eyes), IIA (one eye), and III (two eyes). Three eyes (37%) improved by more than one stage and one eye deteriorated by more than one stage. LSCD is long-lasting and difficult to treat in a short period; thus, it requires careful medical attention.
角膜缘上皮干细胞缺乏（LSCD）是一种由多种原因引起的异常角膜上皮病变。该患者通过荧光素染色进行诊断。大泡性角膜病变、多次手术以及药物相关损伤可导致青光眼患者出现LSCD。我们评估了青光眼患者LSCD的治疗过程。我们回顾性分析了被诊断为LSCD患者的电子病历，并调查了他们的背景、治疗过程以及治疗前后LSCD的分类阶段。采用了邓等人（《角膜》2020年）提出的全球共识分类系统（IA - C期、IIA - B期和III期）。研究了7例患者（2例男性）共8只眼。患者的中位年龄为82岁，青光眼治疗的平均时长为8年。患者患有开角型青光眼（4只眼）、剥脱性青光眼（1只眼）、新生血管性青光眼（1只眼）、正常眼压性青光眼（1只眼）和葡萄膜炎性青光眼（1只眼）。诊断时的分期为4只眼处于IA期，1只眼分别处于IC期、IIA期、IIB期和III期。所有治疗均使用了人工泪液滴眼液、类固醇滴眼液和抗生素。平均治疗时长为1.4年。末次随访时的分期为角膜上皮正常（3只眼）、IA期（2只眼）、IIA期（1只眼）和III期（2只眼）。3只眼（37%）改善超过一个分期，1只眼恶化超过一个分期。LSCD病程持久，短期内难以治疗，因此需要密切的医疗关注。
