ESCRS - P209 - OUTCOME OF AMNIOTIC MEMBRANE TRANSPLANTATION FOR ACUTE OCULAR MANIFESTATIONS IN STEVEN-JOHNSON SYNDROME

OUTCOME OF AMNIOTIC MEMBRANE TRANSPLANTATION FOR ACUTE OCULAR MANIFESTATIONS IN STEVEN-JOHNSON SYNDROME

Published 2023 - 27th ESCRS Winter Meeting

Reference: P209 | Type: Case Report (Cornea Day) | DOI: 10.82333/ca5p-zf77

Authors: Prabhakar Singh* 1 , Amit Raj 1

1Cornea and anterior segment,All India Institute of Medical Sciences, Patna, India,PATNA,India

Purpose

To discuss the effect of amniotic membrane transplantation (AMT)during acute ocular manifestations on long-term sequelae of Steven-Johnson syndrome (SJS)

Setting

Steven-Johnson Syndrome (SJS) is a serious disorder affecting the skin and mucous membrane causing multiple flaccid bullae and purpuric rashes with sheet-like epithelial detachment including the ocular surface. The long-term outcomes following SJS are dismal and manifest as corneal vascularization, lid-wiper keratopathy, and severe dry eyes. The disease course can be modified if an amniotic membrane graft is done in the first week of disease and the above-said complications can be avoided. This procedure thus not only decreases morbidity but also improves the quality of life.

Report of case

This is a case of a 18 years old female presenting with SJS secondary to lamotrigine for myoclonic epilepsy. The patient had bilateral grade 3 ocular involvement. AMT was done for both the eyes on 10th day of iillness. Post-operatively the patient was followed up for potentially blinding long-term complications like corneal conjunctivalization, severe dry eyes, and lid margin keratinization leading to lid-wiper keratopathy. Over 19 months, none of these appeared. 

Conclusion / Take home message

 
  • There should be a low threshold for doing early amniotic membrane transplantation in patients with SJS with ocular surface involvement.
  • Early intervention can change the disease course and decrease disease morbidity significantly.