Purpose: Eye drops, punctal occlusion, and conjunctival surgery have been reported as effective treatments for superior limbic keratoconjunctivitis (SLK). In this study, we retrospectively evaluated the current status of treatment for SLK at Dry Eye Clinic, Department of Ophthalmology, Kyoto Prefectural University of Medicine.
Subjects and methods: In this study, we retrospectively reviewed the records of 77 eyes of 77 patients with SLK (mean age=58.0 years) who visited our Dry Eye Clinic between June 2008 and May 2019. In all subjects, we investigated the treatment outcomes of eye drops, punctal occlusion (in case of no response to eye drops), conjunctival surgery (in case of no response to eye drops and punctal occlusion), as well as complications (e. g., Sjögren syndrome, thyroid disease, and dry eye) and the history of previous blepharoplasty.
Results: Eye drops, punctal occlusion, and conjunctival surgery improved SLK in 24 of 77 patients (31.2%) on average 6.2±5.9 months later, 27 of 35 patients (77.1%) on average 2.8±1.6 months later, and 26 of 26 patients (100%) on average 2.4±1.0 months later, respectively. Concurrent Sjögren syndrome was observed in 15 of 77 patients (19.5%) and thyroid disease was observed in 10 of 31 patients (32.3%) who had antibodies related to thyroid hormones and thyroid gland. Out of 77 patients, 14 patients (18.2%) had a history of blepharoplasty and 60 patients (77.9%) had concurrent dry eye.
Conclusions: For treating SLK, eye drops had a limited effect, whereas punctal occlusion was effective in patients with SLK and aqueous tear-deficient dry eye. Finally, conjunctival surgery was shown to be the most effective treatment.
Nippon Ganka Gakkai Zasshi (J Jpn Ophthalmol Soc) 126: 517-524,2022.