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Corneal limbal stem cell deficiency associated with the anticancer drug S-1

Poster Details

First Author: K.Kim SOUTH KOREA

Co Author(s):    W. Kim                    

Abstract Details


An oral antineoplastic drug S-1 is known to be more effective with less toxicity and fewer gastrointestinal side effects than the conventional intravenous 5-FU. We report a case of limbal stem cell deficiency that occurred in a patient receiving chemotherapy using S-1 alone for gastric cancer.


Referral hospital


A 65-year-old woman with symptoms of grittiness and epiphora in both eyes for several months was referred to the ophthalmology clinic. She had been receiving S-1 orally after total gastrectomy for advanced gastric cancer.


Slit lamp examination revealed irregular hazy epithelium extending to the corneal center overlying the pupil and showing late staining with fluorescein dye. Palisades of Vogt at the superior limbus were absent in both eyes. Best corrected distance vision was 20/50 in both eyes with all other structures of the anterior and posterior segment unremarkable including a patent lacrimal drainage system. There was no change in the corneal lesions of either eye despite three months of topical therapy. The lesions did resolve in four months after discontinuation of S-1 therapy due to acute renal failure.


Early detection of this adverse reaction before significant visual loss through regular follow-up seems to be important in patients receiving S-1 therapy.

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