Focal limbal stem cell deficiency associated with soft contact lens wear

Abstract

ObjectiveThe aim of this study is to summarize the clinical characteristics of patients with contact lens–associated focal limbal stem cell deficiency (FLSCD) from a tertiary corneal referral centre. DesignRetrospective, observational case series in a tertiary care centre. MethodsPatients with contact lens–associated FLCSD were identified in our database. Clinical data were retrieved by chart review. A questionnaire asking for contact lens brand, type, cleaning solution, and duration of contact lens wear was sent to the patients with telephone follow-up. Clinical features and recovery time were identified. ResultsTwenty-seven eyes of 17 patients were identified with superior corneal whorl-like patches of opaque epithelium, sometimes accompanied by neovascularization. Of the patients, 17/17 used soft contact lenses, with a mean wearing duration of 11.4 hours per day. Patients had been wearing lenses for an average of 18.1 years. Silicone hydrogel lenses were noted in 12/17 cases. LSCD was superior in all 27 eyes, and all of them improved with contact lens wear cessation, preservative-free topical steroids, and preservative-free artificial tears. Visual acuity improved from 20/28 to 20/22 (p < 0.001). ConclusionsContact lens–associated FLSCD typically presents in the superior cornea with whorl-like epithelial opacities advancing from the limbus. Conservative medical treatment is available and shows a high success rate after a slow recovery.