Document Detail


Use of fluid-ventilated, gas-permeable scleral lens for management of severe keratoconjunctivitis sicca secondary to chronic graft-versus-host disease.
MedLine Citation:
PMID:  17697963     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Keratoconjunctivitis sicca (KCS) occurs in 40%-60% of patients with chronic graft-versus-host-disease (cGVHD) after allogeneic hematopoietic cell transplantation. Although immunosuppressive therapy is the primary treatment of chronic GVHD, ocular symptoms require measures to improve ocular lubrication, decrease inflammation, and maintain mucosal integrity. The liquid corneal bandage provided by a fluid-ventilated, gas-permeable scleral lens (SL) has been effective in mitigating symptoms and resurfacing corneal erosions in patients with KCS related to causes other than cGVHD. We report outcomes in 9 consecutive patients referred for SL fitting for cGVHD-related severe KCS that was refractory to standard treatments. All patients reported improvement of ocular symptoms and reduced the use of topical lubricants after SL fitting resulting from decreased evaporation. No serious adverse events or infections attributable to the SL occurred. The median Ocular Surface Disease Index improved from 81 (75-100) to 21 (6-52) within 2 weeks after SL fitting, and was 12 (2-53) at the time of last contact, 1-23 months (median, 8.0) after SL fitting. Disability related to KCS resolved in 7 patients after SL fitting. The use of SL appears to be safe and effective in patients with severe cGVHD-related KCS refractory to conventional therapies.
Authors:
Kikuchi Takahide; Pablo M Parker; Michael Wu; William Y K Hwang; Paul A Carpenter; Carina Moravec; Barbara Stehr; Paul J Martin; Perry Rosenthal; Stephen J Forman; Mary E D Flowers
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Publication Detail:
Type:  Journal Article; Research Support, N.I.H., Extramural     Date:  2007-07-20
Journal Detail:
Title:  Biology of blood and marrow transplantation : journal of the American Society for Blood and Marrow Transplantation     Volume:  13     ISSN:  1083-8791     ISO Abbreviation:  Biol. Blood Marrow Transplant.     Publication Date:  2007 Sep 
Date Detail:
Created Date:  2007-08-16     Completed Date:  2007-11-02     Revised Date:  2013-04-29    
Medline Journal Info:
Nlm Unique ID:  9600628     Medline TA:  Biol Blood Marrow Transplant     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1016-21     Citation Subset:  IM    
Affiliation:
Fred Hutchinson Cancer Research Center, Seattle, Washington 98109, USA.
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MeSH Terms
Descriptor/Qualifier:
Adult
Bandages
Chronic Disease
Contact Lenses, Extended-Wear*
Disease Management
Eye Protective Devices*
Graft vs Host Disease / complications*
Humans
Keratoconjunctivitis Sicca / etiology,  therapy*
Middle Aged
Retrospective Studies
Salvage Therapy
Sclera*
Treatment Outcome
Grant Support
ID/Acronym/Agency:
CA018029/CA/NCI NIH HHS; P01 CA018029/CA/NCI NIH HHS; P01 CA018029-31/CA/NCI NIH HHS
Comments/Corrections

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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