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J. Ogawa, Y. Ogawa, M. Dogru, H. Fujishima, H. Matsumoto, K. Tsubota; Therapeutic Applications of Soft Contact Lenses in Severe Dry Eye With Chronic Graft-versus- Host Disease. Invest. Ophthalmol. Vis. Sci. 2007;48(13):372.
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We investigated the efficacy and safety of bandage contact lens for severe dry eye patients with chronic graft-versus-host disease (cGVHD) who were refractory to treatment with non-preserved artificial tears, 20% autologous serum eye drops and punctal occlusion.
A total of 7 patients with severe dry eye due to cGVHD who were refractory to treatment with non-preserved artificial tears, 20% autologous serum eye drops and punctal occlusion were included in this study. The main outcome measures were subjective symptomatic assessment (comfort and pain relief), tear dynamics, and staining of the ocular surface before and after contact lens wear. The patients were fitted with hydrogel contact lenses (n=3) and silicone hydrogel contact lenses (n=4). The follow-up period was over 6 months, and the patients were checked for ocular surface status every 2 or 4 weeks.
Before contact lens wear, the mean Schirmer was score 2.5±2.7mm, and the mean Rose-Bengal stain score was 6.8±1.7 points. In all patients, considerable decrease in pain was observed after therapeutic contact lens wear. Corneal ulcer in one patient was induced by contact lens wear. After 6 month, improvement was observed in the mean fluorescein score from 6.3±2.3 to 2.9±1.5points.
Therapeutic contact lens has bandage effect which stabilized the tear film and protected the ocular surface from trichiasis and fibrotic lid change. We conclude that bandage contact lens is effective for treating severe dry eye with cGVHD. However, the risk of infection must be considered for every patient wearing bandage contact lenses.
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