Abstract ID: 26-198
Surgical burden and success of oculoplastic procedures in Stevens-Johnson-Syndrome/TEN
Author: Cornelius Wiedenmann Base Hospital / Institution: Eye Center, Medical Center, Faculty of Medicine, University of Freiburg, Freiburg im Breisgau, Germany
Presentation Type: ePoster Presentation
Purpose
To investigate the long-term surgical burden and clinical success of oculoplastic interventions in patients with chronic ocular involvement following Stevens-Johnson-Syndrome/Toxic Epidermal Necrolysis (SJS/TEN).
Methods
We conducted a retrospective study of 45 patients (90 eyes) with SJS/TEN. The median age at diagnosis was 24 years, with a median follow-up of 6.4 years (range 0-33). Evaluation focused on surgical frequency per eye, time-dependent complication rates, and the efficacy of anterior lamellar repositioning (ALR).
Results
Chronic lid pathologies showed a delayed manifestation: the median time to onset was 11.1 years for entropion and 10.0 years for trichiasis. Patients faced a median surgical load of 2 interventions per eye (range 0–26). Lid surgery was performed in 89% of patients , with ALR being the most frequent (80%). In 47% of these cases, all four lids were treated. While 78% of ALR cases required only a single intervention per lid , 22% needed re-interventions. ALR with mucous membrane grafting (MMG) proved highly stable, with 5-year success rates of 81.8% for lower lids and 75.5% for upper lids (defined as not requiring another ALR on the same eyelid). Electroepilation showed a median recurrence-free survival of 2.4 years (5-year rate: 37.5%). Anatomical assessment demonstrated stabilization (31 eyes) or improvement (38 eyes) following ALR.
Conclusion
Chronic lid pathologies in SJS often manifest decades after the acute insult therefor requiring consequent ophthalmological examinations. ALR with MMG is an effective causal therapy to stabilize the ocular surface and preserve long-term anatomical integrity.
Additional Authors
| First name | Last name | Base Hospital / Institution |
|---|---|---|
| Sophia | Bauer | Eye Center, Medical Center, Faculty of Medicine, University of Freiburg, Freiburg im Breisgau, Germany |
| Daniel | Böhringer | Eye Center, Medical Center, Faculty of Medicine, University of Freiburg, Freiburg im Breisgau, Germany |
| Thomas | Reinhard | Eye Center, Medical Center, Faculty of Medicine, University of Freiburg, Freiburg im Breisgau, Germany |