+ Site Statistics
+ Search Articles
+ PDF Full Text Service
How our service works
Request PDF Full Text
+ Follow Us
Follow on Facebook
Follow on Twitter
Follow on LinkedIn
+ Subscribe to Site Feeds
Most Shared
PDF Full Text
+ Translate
+ Recently Requested

Comprehensive approach to ocular consequences of Stevens Johnson Syndrome - the aftermath of a systemic condition

Comprehensive approach to ocular consequences of Stevens Johnson Syndrome - the aftermath of a systemic condition

Graefe's Archive for Clinical and Experimental Ophthalmology 252(3): 457-467

Stevens Johnson Syndrome (SJS) can lead to end stage corneal blindness. This study describes the comprehensive treatment measures and their outcomes in the management of ocular sequelae and complications of SJS. Four hundred sixty-four eyes of 232 patients of SJS who underwent surgical intervention (punctal cautery, mucus membrane grafting for lid margin keratinisation, fornix reconstructive procedures, tectonic procedures, keratoplasty and keratoprosthesis) were studied. It was a non-comparative, retrospective, interventional case series. The primary outcome was the change in the best corrected visual acuity (BCVA). Secondary outcome measures included an improvement in the ocular surface status as indicated by corneal epithelial fluorescein staining and Schirmer's I strip wetting. The BCVA and the ocular surface status improved and/or stabilized in > 70 % of eyes following punctal cautery (n = 160) and > 80 % of eyes following lid margin mucus membrane grafting (n = 238). BCVA improved in 50 % of eyes following fornix reconstructive procedures (n = 24) with COMET (n = 6), in 63.9 % eyes with the Prosthetic Replacement of the Ocular Surface Ecosystem (PROSE) lens (n = 36), in 81.8 % of eyes after cataract surgery (n = 22). A BCVA of ≥20/200 was achieved in 72.34 % of eyes following keratoprostheses procedures (n = 47). The mean duration of follow up was 53.3 ± 15.2 months. The ocular sequelae of Stevens Johnson Syndrome can be blinding. They need to be identified and addressed early to retard the continued deterioration of the ocular surface. Our study aims to highlight the problem as well as the importance of comprehensive measures in the management of this potentially blinding disorder.

Please choose payment method:

(PDF emailed within 0-6 h: $19.90)

Accession: 052269990

Download citation: RISBibTeXText

PMID: 24469247

DOI: 10.1007/s00417-014-2568-8

Related references

Ocular aftermath of Stevens-Johnson syndrome. Archives of Ophthalmology 90(5): 376-379, 1973

New surgical approach in cases of cataract with ocular Stevens-Johnson syndrome. Journal of Cataract and Refractive Surgery 42(11): 1549-1555, 2018

Stevens-Johnson Syndrome/Toxic Epidermal Necrolysis--A Comprehensive Review and Guide to Therapy. I. Systemic Disease. Ocular Surface 14(1): 2-19, 2016

The role of systemic immunomodulatory treatment and prognostic factors on chronic ocular complications in Stevens-Johnson syndrome. Ophthalmology 122(2): 254-264, 2015

Systemic and local management at the onset of Stevens-Johnson syndrome and toxic epidermal necrolysis with ocular complications. American Journal of Ophthalmology 149(2): 354; Author Reply 355, 2010

Dacryocystoceles in the aftermath of Stevens-Johnson syndrome. Ophthalmic Plastic and Reconstructive Surgery 21(2): 159-161, 2005

The natural history of Stevens Johnson syndrome: patterns of chronic ocular disease and the role of systemic immunosuppressive therapy. British Journal of Ophthalmology 91(8): 1048-1053, 2007

Chronic Ocular Complications of Stevens-Johnson Syndrome and Toxic Epidermal Necrolysis: The Role of Systemic Immunomodulatory Therapy. Seminars in Ophthalmology 31(1-2): 178-187, 2016

Lingual botryomycoma in the aftermath of Stevens-Johnson syndrome. Pan African Medical Journal 21: 35, 2016

Bilateral conjunctival retention cysts in the aftermath of Stevens-Johnson syndrome. Indian Journal of Ophthalmology 56(1): 70-72, 2007

Effect of age and early intervention with a systemic steroid, intravenous immunoglobulin or amniotic membrane transplantation on the ocular outcomes of patients with Stevens-Johnson syndrome. Korean Journal of Ophthalmology 27(5): 331-340, 2014

Investigation of Monnose-Binding Lectin gene Polymorphism in Patients with Erythema Multiforme, Stevens-Johnson Syndrome and Stevens-Johnson Syndrome/Toxic Epidermal Necrolysis Overlap Syndrome. Balkan Medical Journal 29(3): 310-313, 2012

Toll-like receptor 9 polymorphism in patients with erythema multiforme, Stevens Johnson syndrome and Stevens Johnson syndrome/toxic epidermal necrolysis overlap syndrome. Bratislavske Lekarske Listy 112(5): 260-263, 2011

Muco-cutaneo-ocular syndrome, case of Stevens-Johnson syndrome with grave ocular manifestations. Bollettino d'Oculistica 31(1): 21-40, 1952

Surgical reconstruction of the ocular surface in advanced ocular cicatricial pemphigoid and Stevens-Johnson syndrome. American Journal of Ophthalmology 122(1): 38-52, 1996