Clinical course and efficacy of treatment with limbal-rigid contact lens wear for ocular sequelae in Stevens-Johnson syndrome/toxic epidermal necrolysis.

Purpose: To evaluate the therapeutic efficacy of limbal-rigid contact lens (CL) wear in patients with Stevens-Johnson syndrome (SJS) and toxic epidermal necrolysis (TEN)-related ocular sequelae and to identify factors associated with visual acuity outcomes.

Study design: Retrospective interventional case series.

Methods: 20 patients (23 eyes) with stable SJS/TEN-related ocular surface disease underwent limbal-rigid CL therapy. Patients were stratified into two groups based on baseline best-corrected visual acuity (BCVA): Group 1 (logMAR >1.0, 16 eyes) and Group 2 (logMAR ≤1.0, 7 eyes). BCVA, subjective dryness scores, and objective ocular findings were assessed at baseline and at 1-, 3-, and 6-months post-initiation. Correlations between BCVA at 6 months and baseline ocular findings were analyzed. Bonferroni correction was applied for multiple comparisons.

Results: All patients completed six months of CL wear without serious complications. Group 1 exhibited significant improvement in BCVA, from 1.65±0.45 to 0.98±0.52 immediately after CL wear, with sustained gains throughout follow-up (P < 0.01). Group 2 showed stable BCVA with moderate early effect sizes that did not reach statistical significance. Significant improvements in subjective dryness were observed only in Group 1. A moderate correlation between BCVA at 6 months and upper tarsal scarring was noted, although it did not reach statistical significance after correction.

Conclusions: Limbal-rigid CL therapy appears safe and effective for visual rehabilitation in SJS/TEN-related ocular sequelae, particularly in severe cases. Upper eyelid scarring may influence visual outcomes and warrants further investigation.