title: [Gas-permeable scleral lens for management of severe keratoconjunctivitis sicca secondary to chronic graft-versus-host disease].
abstract: BACKGROUND
  Graft-versus-host disease is a major complication of allogeneic hematopoietic stem cell transplantation. Severe keratoconjunctivitis sicca is common in patients with chronic GVH disease. The goal of this study was to evaluate the safety and efficacy of a gas-permeable scleral lens in the management of severe dry eye disease associated with chronic GVH.
  
  
  METHODS
  This is a retrospective study from June 2009 to November 2013. Patients fitted with scleral lenses for severe keratoconjunctivitis sicca associated with chronic GVH were included. The main outcomes measured were best-corrected visual acuity and quality of life (OSDI and NEI-VFQ25) composite scores before and six months after scleral lens fitting.
  
  
  RESULTS
  Sixteen patients were included. The mean age was 52 years (19-69 years). Mean follow-up was 20 months (3-48 months). All patients reported improvement of their ocular symptoms. Best corrected visual acuity improved from 0.21 ± 0.26 to 0.1 ± 0.14 logMAR (P = 0.002), OSDI score improved from 92.1 ± 11.3 to 23.5 ± 11.2 (P = 0.002) and NEI-VFQ25 improved from 41.3 ± 7 to 83.1 ± 15.9 (P = 0.003), 6 months after scleral lens fitting. No serious adverse events, infectious, hypoxemic or allergic complications attributable to the scleral lens occurred.
  
  
  CONCLUSIONS
  Gas-permeable scleral lens use appears to be safe and effective in patients with severe dry eye related to chronic GVH.
authors.affiliation: Service d'ophtalmologie, hôpital Charles-Nicolle, CHU de Rouen, boulevard Gambetta, 76031 Rouen cedex, France.
authors.forename: P
authors.initials: P
authors.lastname: Rossi
authors.affiliation: Service d'ophtalmologie, hôpital Charles-Nicolle, CHU de Rouen, boulevard Gambetta, 76031 Rouen cedex, France; Service d'ophtalmologie, hôpital Bichat-Claude-Bernard, 46, rue Henri-Huchard, 75018 Paris, France; Service d'ophtalmologie, fondation A.-de-Rothschild, 25, rue Manin, 75019 Paris, France.
authors.forename: A
authors.initials: A
authors.lastname: Delcampe
authors.affiliation: Service d'ophtalmologie, hôpital Charles-Nicolle, CHU de Rouen, boulevard Gambetta, 76031 Rouen cedex, France. Electronic address: julie.gueudry@chu-rouen.fr.
authors.forename: J
authors.initials: J
authors.lastname: Gueudry
authors.affiliation: Service d'ophtalmologie, hôpital Charles-Nicolle, CHU de Rouen, boulevard Gambetta, 76031 Rouen cedex, France.
authors.forename: A
authors.initials: A
authors.lastname: Duncombe
authors.affiliation: Service d'ophtalmologie, hôpital Bichat-Claude-Bernard, 46, rue Henri-Huchard, 75018 Paris, France; Service d'ophtalmologie, fondation A.-de-Rothschild, 25, rue Manin, 75019 Paris, France.
authors.forename: E
authors.initials: E
authors.lastname: Gabison
authors.affiliation: Service d'ophtalmologie, hôpital Bichat-Claude-Bernard, 46, rue Henri-Huchard, 75018 Paris, France; Service d'ophtalmologie, fondation A.-de-Rothschild, 25, rue Manin, 75019 Paris, France.
authors.forename: S
authors.initials: S
authors.lastname: Doan
authors.affiliation: Service d'ophtalmologie, hôpital Charles-Nicolle, CHU de Rouen, boulevard Gambetta, 76031 Rouen cedex, France.
authors.forename: M
authors.initials: M
authors.lastname: Muraine
mesh_terms: D000328:Adult; D000368:Aged; D002908:Chronic Disease; D003263:Contact Lenses, Hydrophilic; D005260:Female; D006086:Graft vs Host Disease / Q000150:complications*; D006801:Humans; D007638:Keratoconjunctivitis Sicca / Q000209:etiology* / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D010100:Oxygen / Q000737:chemistry; D010539:Permeability; D012189:Retrospective Studies; D012590:Sclera; D012720:Severity of Illness Index; D055815:Young Adult
chemical_list: D010100:Oxygen
keywords: Dry eye syndrome; Graft versus host disease; Maladie du greffon contre l’hôte; Quality of life; Qualité de vie; Scleral contact lens; Syndrome sec oculaire; Verres scléraux