title: Thimerosal-induced limbal stem cell failure: report of a case and review of the literature.
abstract: OBJECTIVE
  To report a case of unilateral total limbal stem cell (LSC) failure and corneal opacification secondary to thimerosal- and contact lens-induced ocular surface toxicity.
  
  
  METHODS
  Interventional case report and review of the literature on thimerosal-induced ocular surface changes.
  
  
  RESULTS
  A 49-year-old woman with a 2-year history of long-term soft contact lens wear developed unilateral total LSC failure and corneal opacification secondary to presumed thimerosal-induced toxicity and contact lens wear. At presentation, best-corrected visual acuities were 20/120 in the right eye and 20/15 in the left eye. The patient underwent a keratolimbal allograft and amniotic membrane graft followed by a penetrating keratoplasty. At the last follow-up, the right eye showed a clear corneal graft with a best-corrected visual acuity of 20/30.
  
  
  CONCLUSIONS
  Thimerosal toxicity can lead to total LSC failure with secondary corneal vascularization and opacification. Keratolimbal allograft followed by penetrating keratoplasty can be successful in reconstructing the ocular surface in such cases.
authors.affiliation: St. Paul's Eye Unit, Royal Liverpool University Hospital, Liverpool, United Kingdom.
authors.forename: Dan Q
authors.initials: DQ
authors.lastname: Nguyen
authors.forename: Sathish
authors.initials: S
authors.lastname: Srinivasan
authors.forename: Paul
authors.initials: P
authors.lastname: Hiscott
authors.forename: Stephen B
authors.initials: SB
authors.lastname: Kaye
mesh_terms: D000650:Amnion / Q000637:transplantation; D000891:Anti-Infective Agents, Local / Q000009:adverse effects* / Q000627:therapeutic use; D003261:Contact Lenses / Q000009:adverse effects; D003318:Corneal Opacity / Q000209:etiology* / Q000473:pathology / Q000601:surgery; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007637:Keratoconjunctivitis / Q000473:pathology / Q000628:therapy; D015948:Keratoplasty, Penetrating / Q000379:methods; D016850:Limbus Corneae / Q000166:cytology*; D008875:Middle Aged; D009216:Myopia / Q000628:therapy; D012086:Reoperation; D033581:Stem Cell Transplantation; D013234:Stem Cells / Q000187:drug effects*; D013849:Thimerosal / Q000009:adverse effects* / Q000627:therapeutic use; D014184:Transplantation, Homologous; D017211:Treatment Failure
chemical_list: D000891:Anti-Infective Agents, Local; D013849:Thimerosal