Corneal irregularity of the anterior and posterior surface in patients with limbal stem cell deficiency evaluated with anterior-segment optical coherence tomography.

Abstract

Purpose: To evaluate corneal anterior and posterior irregularities due to limbal stem cell deficiency (LSCD) based on staging using Fourier harmonic analysis with anterior segment optical coherence tomography (AS-OCT).

Study design: Retrospective observational study.

Methods: Patients with LSCD and those without anterior segment disease (controls), examined using AS-OCT, were retrospectively included. Based on Fourier harmonic analysis of the central 3 mm, spherical components, regular astigmatism, asymmetry components, and higher-order irregularities of the anterior, posterior, and total corneas were compared between the groups.

Results: We analyzed 72 eyes of 72 patients-25 eyes of 25 patients (63.0 ± 15.8 years) with LSCD and 47 eyes of 47 patients (66.8 ± 9.5 years) in the control group. Regular astigmatism, asymmetry components, and higher-order irregularities of the anterior, posterior, and total corneas were higher in LSCD than in the control group (all P < 0.001). Based on LSCD staging, asymmetry components of the total cornea were higher in LSCD stages I, II, and III than in the controls (P = 0.034, P < 0.001, and P < 0.001, respectively). Additionally, higher-order irregularity was larger in stages II and III of LSCD than in the controls (all P < 0.001). The higher-order irregularity in LSCD significantly correlated with best-corrected visual acuity (P = 0.034).

Conclusion: Corneal irregularities in the anterior and posterior corneas increased in patients with LSCD and contributed to best-corrected visual acuity. Even in patients at stage I, where the lesion spared the central 5 mm, an increase in asymmetric astigmatism within the central 3 mm was observed.