Abstract Listings 2024

Purpose

Ocular Stevens Johnson (SJS) is rare immune-mediated disease that can lead to blindness. Appropriate treatment in acute phase is important in reducing extent of chronic disease. Even when treated aggressively in acute phase, chronic phase can still cause visual failure. This video represents ocular findings in acute ocular SJS and its management.

Methods

A thirty-four old man emerges from Intensive Care Unit with systemic skin lesions involving more than 30 % of the total body surface area therefore classified as most severe form calling Toxic Epidermal Necrolysis (TEN) caused by oral ciprofloxacin. Initial eye symptoms included bilateral conjunctival hyperemia, discharge and pseudo-membrane formation. Despite aggressive removal of pseudo membranes in first few days severe ocular manifestation-corneal ulceration occurs and urgent bilateral Amnion Membrane Transplantation was performed.

Results

Preoperative visual acuity was uncorrected bilateral 0.05. Surgery was obtained under general anesthesia. The pseudo-membrane and corneal epithelial defect was debrided and conjunctival symblepharon was dissected. Amniotic Membrane was placed stromal side in direction of corneal epithelial defect and attached with fibrin glue. In early postoperative period silicon corneal shield covered AMT. Anti-inflammatory and anti-scaring attributes of Amniotic Membrane supported corneal healing. On postoperative day 15 visual acuity on right eye was uncorrected 0.3 and on left eye 0.8.

Conclusion

Urgent AMT should be performed as soon as possible when significant corneal epithelial defects are seen in acute severe ocular SJS.

Additional Authors

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