The outcomes of corneal sight rehabilitating surgery in Stevens-Johnson syndrome: case series.
Humans
Stevens-Johnson Syndrome
/ surgery
Retrospective Studies
Female
Male
Adult
Visual Acuity
/ physiology
Middle Aged
Young Adult
Adolescent
Corneal Diseases
/ surgery
Treatment Outcome
Child
Corneal Transplantation
/ methods
Follow-Up Studies
Keratoplasty, Penetrating
/ methods
Postoperative Complications
Limbus Corneae
/ surgery
Keratolimbal allograft
Keratoplasty
Ocular SJS
Stevens-Johnson syndrome
Toxic epidermal necrolysis
Journal
BMC ophthalmology
ISSN: 1471-2415
Titre abrégé: BMC Ophthalmol
Pays: England
ID NLM: 100967802
Informations de publication
Date de publication:
06 May 2024
06 May 2024
Historique:
received:
07
02
2024
accepted:
21
04
2024
medline:
7
5
2024
pubmed:
7
5
2024
entrez:
6
5
2024
Statut:
epublish
Résumé
To summarize the outcomes of corneal sight rehabilitating surgery in Stevens-Johnson syndrome (SJS). This is a retrospective analysis of a consecutive case series. Twenty-four eyes of 18 SJS patients were included in this study. The ocular parameters, surgical procedures, postoperative complications, and additional treatments of the cases were reviewed. A total of 29 corneal sight rehabilitating surgeries, which consists of 9 keratoplasties, 8 Keratolimbal allograft (KLAL) and 12 combined surgeries (keratoplasty and KLAL simultaneously) were performed on the 24 eyes. All patients were treated with glucocorticoid eyedrops and tacrolimus eyedrops for anti-rejection treatment without combining systemic immunosuppression, except two patients who were prescribed prednisone tablets for the management of systemic conditions. The mean follow-up period was 50.6 ± 28.1 months. The optimal visual acuity (VA) (0.74 ± 0.60 logarithm of the minimum angle of resolution [logMAR]) and endpoint VA (1.06 ± 0.82 logMAR) were both significantly better than the preoperative VA (1.96 ± 0.43 logMAR) (95% CI, p = 0.000). 57.1% patients (8/14) were no longer in the low vision spectrum, and 88.9% patients (8/9) were no longer blind. The mean epithelialization time was 7.1 ± 7.6 weeks. The success rate was 86.7%. Additional treatments for improving epithelialization included administration of serum eyedrops (n = 10), contact lens (n = 15), amniotic membrane transplantation (n = 6), and tarsorrhaphy (n = 8). Complications included delayed epithelialization (n = 4, over 12 weeks), glaucoma (n = 11), and severe allograft opacity (n = 4). Only one graft rejection was observed. Keratoplasty and KLAL can remarkably enhance VA and improve low vision or even eliminate blindness for ocular complications of SJS. The outcome of the surgeries was correlated with the preoperative ocular situation and choice of operative methods.
Identifiants
pubmed: 38711013
doi: 10.1186/s12886-024-03461-2
pii: 10.1186/s12886-024-03461-2
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
205Subventions
Organisme : National Natural Science Foundation of China
ID : 82371027
Informations de copyright
© 2024. The Author(s).
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