Objective To conduct a review and meta-analysis for investigating the relative reduction of central corneal basal cell density (BCD) and nerve parameters in ocular surface disease (OSD) and limbal stem cell deficiency (LSCD).

Methods A systematic literature search using the terms ((1) “ocular surface disease” or “ocular surface disorder”; (2) “in vivo confocal microscopy”; (3) “limbal stem cell deficiency”; (4) “basal cell density” or “corneal basal cell density” or “central corneal basal cell density”; (5) “corneal nerves” or “corneal nerve parameters” or “central corneal nerve parameters”) was performed. The results are presented as weighted mean difference (WMD) with corresponding 95% CI.

Results 16 studies that reported the central corneal BCD and 21 studies that reported the central corneal nerve parameters in OSD (including LSCD) were included. A significant reduction in central corneal BCD was observed in patients with various OSDs (WMD=−9.50, 95% CI −14.04 to −4.97, p<0.01) as well as in patients with LSCD (WMD=−22.14, 95% CI −37.91 to −6.37, p<0.01) compared with healthy controls, however, no significant difference in BCD was observed between the two groups (WMD=−11.61, 95% CI −15.96 to −7.26, p=0.13). There was no conclusive difference in various central corneal nerve parameters between OSDs and LSCD.

Conclusion Central corneal BCD and nerve parameters are reduced in LSCD, there is a similar reduction in other OSDs.