scholarly journals Sutureless dehydrated amniotic membrane for persistent epithelial defects

2021 ◽  
pp. 112067212110113
Author(s):  
Michael Mimouni ◽  
Tanya Trinh ◽  
Nir Sorkin ◽  
Eyal Cohen ◽  
Gisella Santaella ◽  
...  
Keyword(s):  
Amniotic Membrane ◽  
Stevens Johnson Syndrome ◽  
Eye Disease ◽  
Severe Allergic Reaction ◽  
Graft Versus Host ◽  
Johnson Syndrome ◽  
Limbal Stem Cell ◽  
Persistent Epithelial Defects

Purpose: To report outcomes of a sutureless dehydrated amniotic membrane for persistent epithelial defects (PED). Methods: This retrospective study included consecutive patients with a PED (⩾14 days) treated with a sutureless dehydrated amniotic membrane and bandage contact lens (BCL). Included were patients with an epithelial defect that did not respond to treatment with a BCL. Excluded were patients with a follow-up time of less than 3 months. Results: Nine eyes of eight patients with a mean age of 54.6 ± 10.9 years (range 38–73 years) were included in this study. The main etiology of the PED was limbal stem cell deficiency ( n = 5/9) due to Stevens-Johnson Syndrome ( n = 2/5), glaucoma procedures ( n = 1/5), graft-versus-host disease ( n = 1/5) and severe allergic reaction ( n = 1/5). Additional etiologies included neurotrophic cornea ( n = 2/9), post keratoplasty and severe dry eye disease ( n = 2/9). Time from PED presentation to amnion treatment was 65.9 ± 60.6 days (range 15–189 days) with the area of the PED being 11.0 ± 12.2 mm2 (range 1.0–36.0 mm2). The amnion was absorbed within 2 weeks in 100% of the cases. Following insertion of the amnion, resolution of the PED was achieved in 8/9 eyes (89%) without the need for additional interventions within 17.8 ± 9.6 days (range 7–35 days). LogMAR BCVA improved from 0.94 ± 0.88 to 0.37 ± 0.25 ( p = 0.036) with no complications or recurrences recorded. Conclusions: Sutureless dehydrated amniotic membrane achieved resolution of PEDs secondary to various etiologies in 89% of eyes with a significant improvement in vision demonstrated. Further studies are needed to assess long term safety and effectiveness.

Oral mucous membrane grafts for total symblepharon and lid margin keratinisation post Stevens-Johnson syndrome

2020 ◽  
Vol 13 (10) ◽  
pp. e239383 ◽  
Author(s):  
Priyanka Sudana ◽  
Sayan Basu ◽  
Swapna S Shanbhag
Keyword(s):  
Visual Acuity ◽  
Mucous Membrane ◽  
Surface Damage ◽  
Stevens Johnson Syndrome ◽  
Oral Ulcers ◽  
Johnson Syndrome ◽  
History Of ◽  
Limbal Stem Cell ◽  
The Right

A female patient in her late 40s presented with severe visual impairment and a history of oral ulcers, necrolysis of skin and hospitalisation after using gabapentin for neck pain 10 months ago. She was a diagnosed case of Stevens-Johnson syndrome (SJS) with chronic ocular sequelae—with total symblepharon and keratinised lid margins in the left eye and limbal stem cell deficiency and severe dryness in the right eye. Her visual acuity was perception of light in both eyes. She underwent left eye symblepharon release with autologous labial mucous membrane grafts (MMGs) for surface reconstruction and subsequent lid margin MMG for lid margin keratinisation. Best-corrected visual acuity improved to 20/25 with scleral lens in the left eye, which was sustained over 1 year of follow-up. Labial mucosa acts as a useful and easily accessible alternative to conjunctiva in eyes with bilateral severe ocular surface damage and total symblepharon secondary to SJS.

Long-term visual outcomes of the Boston type I keratoprosthesis in Canada

2020 ◽  
pp. bjophthalmol-2019-315345 ◽  
Author(s):  
Andrei-Alexandru Szigiato ◽  
Cristina Bostan ◽  
Taylor Nayman ◽  
Mona Harissi-Dagher
Keyword(s):  
Risk Factors ◽  
Stevens Johnson Syndrome ◽  
Type I ◽  
Complication Rates ◽  
Visual Outcomes ◽  
Johnson Syndrome ◽  
Visual Failure ◽  
Boston Type I Keratoprosthesis

Background/aimsTo evaluate long-term visual outcomes of Boston type I keratoprosthesis (KPro) surgery and identify risk factors for visual failure.MethodsSingle surgeon retrospective cohort study including 85 eyes of 74 patients who underwent KPro implantation to treat severe ocular surface disease, including limbal stem cell deficiency, postinfectious keratitis, aniridia and chemical burns. Procedures were performed at the Centre hospitalier de l'Université de Montréal from October 2008 to May 2012. All patients with at least 5 years of follow-up were included in the analysis, including eyes with repeated KPro. Main outcome measures were visual acuity (VA), visual failure, defined as a sustained worse than preoperative VA, postoperative complications, and device retention.ResultsMean follow-up was 7.2±1.3 years (±SD). Mean VA was 2.1±0.7 (logarithm of minimal angle resolution) preoperatively and 1.9±1.2 at last follow-up. There were 2.4% of patients with VA better than 20/200 preoperatively and 36.5% at last follow-up. Maintenance of improved postoperative VA was seen in 61.8% of eyes at 7 years. Preoperative factors associated with visual failure were known history of glaucoma (HR=2.7 (1.2 to 5.9), p=0.02) and Stevens-Johnson syndrome (HR=7.3 (2.5 to 21.4) p<0.01). Cumulative 8-year complication rates were 38.8% retroprosthetic membrane formation, 25.9% hypotony, 23.5% new onset glaucoma, 17.6% retinal detachment, 8.2% device extrusion and 5.9% endophthalmitis. The majority (91.8%) of eyes retained the device 8 years after implantation.ConclusionAlmost two-thirds of patients had improved VA 7 years after KPro implantation. Preoperative risk factors for visual failure were known glaucoma and Stevens-Johnson syndrome.

Complete Fusion of Both Eyelids in Stevens-Johnson Syndrome: Case Report

2021 ◽  
Author(s):  
Joseph A Santamaria ◽  
Leopoldo C Cancio ◽  
Donovan Reed ◽  
Hunter Phillips ◽  
Sien Chen ◽  
...  
Keyword(s):  
Amniotic Membrane ◽  
Early Recognition ◽  
Stevens Johnson Syndrome ◽  
Ocular Involvement ◽  
Complete Fusion ◽  
Visual Disability ◽  
Burn Center ◽  
Ophthalmic Ointment ◽  
Johnson Syndrome

Abstract An 18-year-old woman developed Stevens-Johnson syndrome (SJS) with ocular involvement after taking ibuprofen. She was admitted to another hospital, received saline flushes and bacitracin ophthalmic ointment to the eyes, and became unable to open them. Upon transfer to this burn center 3 weeks after symptom onset, there was complete fusion of both eyelids with no visible cornea or sclera. She underwent bilateral operative scar release. After opening the lids, meticulous debridement of cicatricial membranes and release of symblephara were performed with subsequent placement of amniotic membrane grafts. Her vision slowly improved, though her long-term visual prognosis remains guarded. Early recognition and treatment of SJS or toxic epidermal necrolysis (TEN) with ocular involvement is imperative. Even mild cases may require intensive topical lubrication, steroids, and antibiotics, with early placement of amniotic membrane grafts in severe cases. Prompt intervention and daily evaluation are paramount in preventing lifelong visual disability.

Long-term Progression of Ocular Surface Disease in Stevens–Johnson Syndrome and Toxic Epidermal Necrolysis

Cornea ◽  
2020 ◽  
Vol 39 (6) ◽  
pp. 745-753
Author(s):  
Yamato Yoshikawa ◽  
Mayumi Ueta ◽  
Hideki Fukuoka ◽  
Tsutomu Inatomi ◽  
Isao Yokota ◽  
...  
Keyword(s):  
Toxic Epidermal Necrolysis ◽  
Ocular Surface ◽  
Ocular Surface Disease ◽  
Stevens Johnson Syndrome ◽  
Johnson Syndrome

scholarly journals Characteristics and recurrence of pterygium in Saudi Arabia: a single center study with a long follow‐up

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Waleed Alsarhani ◽  
Saeed Alshahrani ◽  
Mahmood Showail ◽  
Nawaf Alhabdan ◽  
Osama Alsumari ◽  
...  
Keyword(s):  
Mitomycin C ◽  
Recurrence Rate ◽  
Dry Eye ◽  
Amniotic Membrane ◽  
Univariate Analysis ◽  
Dry Eye Disease ◽  
Eye Disease ◽  
First Year ◽  
Conjunctival Autografting

Abstract Background This study described the clinical features of patients with pterygium and analyzed the recurrence rate of conjunctival autografting alone, conjunctival autografting combined with intraoperative mitomycin C, and amniotic membrane grafting. Methods A retrospective cohort study of primary pterygium was conducted between January 2017 and February 2020. Factors associated with pterygium severity and recurrence were analyzed by univariate analysis and logistic regression models. Results The study included 292 patients with an average age of 53.3 ± 14.1 years, while the number of operated cases was 94. Pterygia involving the cornea were observed in 55 % of the cases. The overall rate of recurrence for the three procedures was 17 %. The average time of recurrence was 14.2 ± 11.9 months, with 37 % of the recurrences occurring after the first year. The only factor associated with a significant risk of recurrence was dry eye disease in both univariate (p = 0.021) and multivariate analysis (p = 0.026). The recurrence rates following conjunctival autografting with and without mitomycin C were 15.6 and 15.8 %, respectively. The recurrence rate following the amniotic membrane graft was  twofold (OR= 2.02)  (27 %) that following the conjunctival autograft (15.8 %). Conclusions The only factor associated with the recurrence of pterygium was dry eye disease. More than one-third of recurrences developed after the first year, which stresses the importance of a long follow-up. The recurrence rate in our study following conjunctival graft was slightly higher compared to the literature mainly due to differences in study areas, populations, and follow-up periods.

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