Background/Aims To investigate the efficacy of therapeutic soft contact lenses (SCLs) in gelatinous drop-like corneal dystrophy (GDLD) management.
Methods This was a retrospective, consecutive, observational case series, including 20 patients (40 eyes) with GDLD treated in Osaka University Hospital within the last 15 years. We tested the effects of therapeutic SCL on clinical features, visual acuity and surgical interventions. Examinations for clinical features and visual acuity were done on patients who had no surgical intervention for 3 years. Scoring and evaluation of changes in three main clinical GDLD features and visual acuity (logMAR units) were performed using Fisher’s exact test and Mann-Whitney U test. Surgery-free survival time was compared by Kaplan-Meier analyses in all patients.
Results We found a significantly lower rate of progression in GDLD nodular lesions in patients wearing SCLs compared with those who did not (p=0.0179). No suppressant effects were observed regarding opacity and neovascularisation, and no significant improvements were found in visual acuity (in logMAR values, SCL-on: mean=− 0.036, median=0; SCL-off: mean=0.149, median=+ 0.088; p=0.14). The surgery-free survival time for all 16 SCL-on eyes was 2770 ± 1918 days, significantly longer than that for 22 SCL-off eyes, 1342 ± 1323 days (Kaplan-Meier analysis, p=0.0007), suggesting that therapeutic SCL extends the period until surgical intervention and reduces their necessity in patients with GDLD.
Conclusion Wearing therapeutic SCLs in GDLD slows the progression of nodular lesions and decreases the need for surgical interventions.
- corneal dystrophy
- soft contact lens
- nodular lesions
- visual acuity
- surgical intervention
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Contributors SM, TS, MT and RS designed and directed the project and interpreted data. SM and MT wrote the manuscript. TS, RK, YO, SK, KM, SK, NM and KN revised the manuscript and provided critical advice regarding discussion. Additionally, all authors discussed the results and commented on the manuscript.
Funding This work was supported by JSPS KAKENHI Grant Number JP 17K11448 to Tsujikawa.
Competing interests During the conduct of the study, MT received grants from Japan Society of Promotion of Science and NM received personal fees from Alcon. MT reports personal fees from Santen and Alcon, outside the submitted work. TS reports personal fees from HOYA, Santen, Otsuka, Nitto Medic, Pfizer and Senju, outside the submitted work. RK reports grants and personal fees from Novartis, Pfizer, Senju and Bayer; personal fees from Alcon, Kowa and Santen and other fees from Topcon, Predictive analytics, Office Future, and MICIN, outside the submitted work. YO reports personal fees from Senju, Santen, Alcon Japan and Otsuka, outside the submitted work. KN reports personal fees from Alcon, Menicon, Oculus, Otsuka, Santen and Seed; grants and personal fees from Johnson & Johnson; and grants from Shire, outside the submitted work. NM reports grants from Topcon, the Japanese Ministry of the Education, Culture, Sports, Science and Technology, and the Japanese Ministry of Health, Labor and Welfare; personal fees from AMO, Alcon, B+L, HOYA, Oculus, Santen, Senjyu, Tomey, Menicon and Pfizer, outside the submitted work. KN reports personal fees from Senju, Otsuka, Japan Tissue Engineering, Santen, Alcon, Carl Zeiss, HOYA, Johnson & Johnson, Novartis, Pfizer, Wakamoto, Seed and Nidek, outside the submitted work.
Patient consent for publication Not required.
Ethics approval The study was approved in advance by the Institutional Review Board/Ethics Committee of Osaka University.
Provenance and peer review Not commissioned; externally peer reviewed.