title: Scleral lenses for severe chronic GvHD-related keratoconjunctivitis sicca: a retrospective study by the SFGM-TC.
abstract: Chronic GvHD-related keratoconjunctivitis sicca (cGvHD-related KCS) can significantly alter the quality of life of patients after allogeneic hematopoietic stem cell transplantation. The aim of this work was to assess the efficacy and tolerability of scleral lenses to treat severe cGvHD-related KCS. In this retrospective, multicenter study, we included 60 consecutive patients diagnosed with cGvHD-related KCS and fitted with scleral lenses. Patients were evaluated at baseline and at 2 months with the following tests: the Ocular Surface Disease Index (OSDI) to assess quality of life, the Oxford score to grade corneal damage and the logarithm of minimal angle of resolution (Log MAR) scale to determine visual acuity. We observed improvement in quality of life in 58 patients (97%). All parameters improved at 2 months. We observed significant differences at 2 months compared with baseline for the mean OSDI (86 versus 30, respectively, P<0.001), the mean Oxford score (3.2 versus 1.3, respectively, P<0.001) as well as visual acuity (Log MAR of 0.33 versus 0.10, respectively, P<0.001). Treatment with scleral lenses was discontinued in only 5 patients (8%) with a median follow-up of 20.5 months (range: 2-125 months). Scleral lenses were very efficient and well tolerated in patients with severe cGvHD-related KCS.
authors.affiliation: CHRU Lille, Pôle Spécialités Médicales et Gérontologie, Service des Maladies du Sang, Secteur Allogreffe de Cellules Souches Hématopoïétiques, Lille, France.|Université de Lille, UFR Médecine, Lille, France.
authors.forename: L
authors.initials: L
authors.lastname: Magro
authors.affiliation: CHRU Lille, Pôle Spécialités Médicales et Gérontologie, Service des Maladies du Sang, Secteur Allogreffe de Cellules Souches Hématopoïétiques, Lille, France.|Université de Lille, UFR Médecine, Lille, France.
authors.forename: J
authors.initials: J
authors.lastname: Gauthier
authors.affiliation: CH Tourcoing, Service d'Ophtalmologie, Tourcoing, France.
authors.forename: M
authors.initials: M
authors.lastname: Richet
authors.affiliation: Service d'hématologie, Hôpital Saint-Louis, Paris, France.
authors.forename: M
authors.initials: M
authors.lastname: Robin
authors.affiliation: APHP, Hôpital La Pitié Salpêtrière, Service d'Hématologie, Paris, France.
authors.forename: S
authors.initials: S
authors.lastname: Nguyen
authors.affiliation: Hématologie, Hôpital Necker, Paris, France.
authors.forename: F
authors.identifier: http://orcid.org/0000-0002-3537-9052
authors.initials: F
authors.lastname: Suarez
authors.affiliation: Hôpital Robert Debré, Paris, France.
authors.forename: J-H
authors.initials: JH
authors.lastname: Dalle
authors.affiliation: CHU Haut-Lévêque, Service d'Hématologie et de Thérapie Cellulaire, Bordeaux, France.
authors.forename: T
authors.initials: T
authors.lastname: Fagot
authors.affiliation: CHU Toulouse, Hôpital Purpan, Service d'Hématologie, Toulouse, France.
authors.forename: A
authors.initials: A
authors.lastname: Huynh
authors.affiliation: CHRU Nancy, Service d'Hématologie et Médecine Interne, Hôpital Brabois, Vandoeuvre les Nancy, France.
authors.forename: M-T
authors.initials: MT
authors.lastname: Rubio
authors.affiliation: CHU Caen, Service d'Hématologie, Caen, France.
authors.forename: R
authors.initials: R
authors.lastname: Oumadely
authors.affiliation: CHU Haut-Lévêque, Service d'Hématologie et de Thérapie Cellulaire, Bordeaux, France.
authors.forename: S
authors.initials: S
authors.lastname: Vigouroux
authors.affiliation: CHU Haut-Lévêque, Service d'Hématologie et de Thérapie Cellulaire, Bordeaux, France.
authors.forename: N
authors.initials: N
authors.lastname: Milpied
authors.affiliation: CHU Rouen, Service d'Ophtalmologie, Rouen, France.
authors.forename: A
authors.initials: A
authors.lastname: Delcampe
authors.affiliation: CHRU Lille, Pôle Spécialités Médicales et Gérontologie, Service des Maladies du Sang, Secteur Allogreffe de Cellules Souches Hématopoïétiques, Lille, France.|Université de Lille, UFR Médecine, Lille, France.|LIRIC, INSERM U995, Lille, France.
authors.forename: I
authors.initials: I
authors.lastname: Yakoub-Agha
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D064591:Allografts; D002648:Child; D002908:Chronic Disease; D005260:Female; D006086:Graft vs Host Disease / Q000473:pathology / Q000628:therapy; D018380:Hematopoietic Stem Cell Transplantation; D006801:Humans; D007638:Keratoconjunctivitis Sicca / Q000209:etiology / Q000473:pathology / Q000628:therapy; D007903:Lens Capsule, Crystalline / Q000473:pathology*; D008297:Male; D008875:Middle Aged; D011788:Quality of Life; D012189:Retrospective Studies; D012720:Severity of Illness Index