Clinical Ophthalmology (Dec 2021)
Scleral Lens and Prosthetic Replacement of the Ocular Surface Ecosystem Utilization in Ocular Graft-versus-Host Disease: A Survey Study
Abstract
Shannon M Bligdon,1 Bradley A Colarusso,2 Allen Y Ganjei,3 Alan Kwok,4 Zhonghui Katie Luo,2 Daniel Brocks4 1Ajax Eye Care, Ajax, ON, Canada; 2Massachusetts Eye and Ear, Boston, MA, USA; 3Drexel University College of Medicine, Philadelphia, PA, USA; 4BostonSight, Needham, MA, USACorrespondence: Alan KwokBostonSight, 464 Hillside Ave, Unit 205, Needham, MA, 02494, USATel +1 781 726 7337Fax +1 781 726 7310Email [email protected]: To evaluate the utilization of scleral lenses and prosthetic replacement of the ocular surface ecosystem devices (SL/PDs) in the management of ocular graft-versus-host disease (oGVHD).Patients and Methods: A survey of 15 questions was sent via email to 6032 subjects registered with the Blood and Marrow Transplant Information Network. The survey reviewed transplant history, graft-versus-host disease history, as well as oGVHD symptoms and onset. Additional questions surveyed treatments used for oGVHD, as well as the degree of ocular symptom control and experience with SL/PDs. A total of 306 respondents met the eligibility requirements to be part of the analyzed cohort.Results: The mean number of symptoms reported from the analyzed cohort was 4.79 ± 2.44, median (IQR) of 5.0 (3.0 to 7.0), with the most common symptom being gritty, dry eyes (87%). The mean number of treatments utilized across the analyzed cohort was 3.21 ± 2.55, median (IQR) of 2.5 (1.0 to 5.0), with the most common treatment being artificial tears (86%). Wearing scleral lenses resulted in a mean of 5.42 ± 1.86, median (IQR) of 6.0 (4.0 to 7.0) symptoms improving, with improved dryness/grittiness of the eyes (94%), improved eye pain (92%) and improved quality of life (89%) being the most commonly improved symptoms. Fifty-six percent of those wearing scleral lenses wished the lenses had been recommended sooner. The most common reason patients cited for not wearing scleral lenses was that they had never heard of them (63%).Conclusion: SL/PDs help to control the symptoms of oGVHD. With their use, clinicians are able to improve the quality of life of this patient population. Despite the known benefits, SL/PDs still remain underutilized in oGVHD care. A majority of current SL/PD wearers wish that they had been recommended sooner as a treatment option. SL/PDs should be considered a component of comprehensive oGVHD management.Keywords: GVHD, oGVHD, dry eye, keratoconjunctivitis sicca, QOL, HSCT, allo-HSCT
