Limbal stem cell deficiency: Demography, aetiology, and clinical presentation in Eastern India

To determine demographic details, clinical profile, and underlying causes of limbal stem cell deficiency.

Descriptive cross-sectional study.

Patients visiting tertiary referral hospitals between January 2019 and December 2022 who satisfy the criteria for labeling limbal stem cell deficiency (LSCD) were enrolled. Parameters such as age, gender, region, duration, aetiology, and clinical features were noted. Descriptive statistics was applied. The student t-test was used.

A total of 731 eyes of 489 patients with LSCD were included in our study, with age ranging from 5 to 85 years (35.0 ± 19.4 years). The most common presenting complaints were a decrease in vision 473 (96.7%), most of them 342 (69.7%) are having history of gradual progression (>3 months), and 245 (50.1%) have bilateral involvement of eyes. Average corneal clarity was found to be grade 1.6 ± 1.2 and average corneal superficial neovascularization was found to be 7.9 ± 4.3 quadrants. Clinically, we found LSCD of about up to 90° in 57 eyes, 90 to 180° in 71 eyes, 215 eyes with 180 to 270°, and the rest of 388 eyes were having more than 270° of LSCD involvement. Out of 489 patients, 142 (29.0%) patients were of chemical injury, 125 (25.6%) patients were of Steven Johnson syndrome (SJS)/toxic epidermal necrolysis (TEN), followed by 61 (12.5%) patients of vernal keratoconjunctivitis (VKC).

The majority of patients were young males presented with more than 270° LSCD and vision <2/60. In our study, chemical injury was most common in unilateral LSCD and SJS/TEN in bilateral LSCD.