Corneal irregularity of the anterior and posterior surface in patients with limbal stem cell deficiency evaluated with anterior-segment optical coherence tomography.

PURPOSE

To evaluate corneal anterior and posterior irregularities due to limbal stem cell deficiency (LSCD) based on staging using Fourier harmonic analysis with anterior segment optical coherence tomography (AS-OCT).

STUDY DESIGN

Retrospective observational study.

METHODS

Patients with LSCD and those without anterior segment disease (controls), examined using AS-OCT, were retrospectively included. Based on Fourier harmonic analysis of the central 3 mm, spherical components, regular astigmatism, asymmetry components, and higher-order irregularities of the anterior, posterior, and total corneas were compared between the groups.

RESULTS

We analyzed 72 eyes of 72 patients-25 eyes of 25 patients (63.0 ± 15.8 years) with LSCD and 47 eyes of 47 patients (66.8 ± 9.5 years) in the control group. Regular astigmatism, asymmetry components, and higher-order irregularities of the anterior, posterior, and total corneas were higher in LSCD than in the control group (all P < 0.001). Based on LSCD staging, asymmetry components of the total cornea were higher in LSCD stages I, II, and III than in the controls (P = 0.034, P < 0.001, and P < 0.001, respectively). Additionally, higher-order irregularity was larger in stages II and III of LSCD than in the controls (all P < 0.001). The higher-order irregularity in LSCD significantly correlated with best-corrected visual acuity (P = 0.034).

CONCLUSION

Corneal irregularities in the anterior and posterior corneas increased in patients with LSCD and contributed to best-corrected visual acuity. Even in patients at stage I, where the lesion spared the central 5 mm, an increase in asymmetric astigmatism within the central 3 mm was observed.