Contact Lens Induced Limbal Stem Cell Deficiency: Clinical Features in Korean Patients

Purpose

To describe the clinical features of Korean patients with contact lens-induced limbal stem cell deficiency (CL-LSCD).

Methods

Medical records of 22 patients who were diagnosed with CL-LSCD between 2014 and 2019 were reviewed retrospectively. Outcome measures included demographics, clinical presentation, treatment, clinical course, and pattern of contact lens (CL) wear.

Results

Forty-two eyes of 22 patients were found to have typical changes associated with CL-LSCD. Twenty (91%) patients were women and mean age was 36 ± 12 years. All patients had myopia with mean spherical equivalent of −7.52 ± 3.2 diopter. Twenty (91%) patients had bilateral disease and the location of limbal involvement was diffuse in 20 eyes (47.6%) and partial in 22 eyes (52.4%, superior in 20 eyes and inferior in 2 eyes). Fourteen (63.6%) patients complained of decreased visual acuity. Average period of CL wear was 14 ± 9 years. Four patients used cosmetic colored CLs and four patients had a history of overnight CL wear. All 12 patients who completed follow-up (28 ± 42 weeks) showed improvement in visual acuity and ocular surface condition after cessation of CL wear and medical treatment. Of them, five (42%) patients showed full recovery while seven (58%) showed partial recovery.

Conclusions

If a patient with a history of CL wear for an extended period of time presents with decreased visual acuity, practitioners should perform detailed examinations with suspicion of CL-LSCD, including fluorescein staining. CL-LSCD is usually reversible and close follow-up with conservative treatment is recommended as the initial treatment option.

ToF-SIMS and AFM Characterization of Brown Cosmetic Contact Lenses: From Structural Analysis to the Identification of Pigments

Over the years, soft contact lenses for vision correction and cosmetic and therapeutic purposes have been greatly improved. For cosmetic contact lenses, the pigments need to be nontoxic, and the position of the pigment layer is particularly important because of the risks posed by pigment elution and the roughness of the lens surface. In this paper, we characterized the properties of brown cosmetic contact lenses made by three different manufacturers using surface analytical techniques. The surface topographies of the noncolored and colored parts were obtained by atomic force microscopy (AFM), and the position and composition of the pigment layer were determined by analyzing the cross section of the contact lenses using scanning electron microscopy with energy-dispersive X-ray spectroscopy (SEM-EDX). The influence of pigment location on surface roughness was also examined. In addition, to find the method of the evaluation for the risk of surface elution of the pigments in the colored parts, the mass spectra and ion images of the surfaces were obtained by time-of-flight secondary ion mass spectrometry (ToF-SIMS) with a new sample preparation. From the ToF-SIMS spectra, we observed specific fragment ions of the poly(hydroxyethyl methacrylate) (PHEMA) polymer and found differences in the composition of the pigment layer depending on the manufacturers. The cross-sectioned image and 3D chemical characterizations of metallic and specific ions in the brown cosmetic contact lenses clearly indicated the spatial distribution and location of the pigment layer that can be used for the evaluation of pigment elution.

A review of cosmetic contact lens infections

This paper provides a comprehensive review of the existing literature surrounding cosmetic contact lens infections. In this paper, lens-related, dispensing-related and patient-related factors are examined in detail.