Treatment of acute Stevens-Johnson syndrome and toxic epidermal necrolysis using amniotic membrane: a review of 10 consecutive cases

Abstract

Purpose: To describe the clinical course, treatments, and outcomes of 10 consecutive patients treated with amniotic membrane transplantation (AMT) applied to the eyelid margins, palpebral conjunctiva, and ocular surface during the acute phase of Stevens-Johnson syndrome (SJS) or toxic epidermal necrolysis (TEN).

Design: Prospective case series of 10 consecutive patients treated by 1 surgeon.

Participants: Ten consecutive patients with severe ocular surface and eyelid inflammation treated with AMT during the acute phase of SJS or TEN.

Intervention: Cryopreserved amniotic membrane was applied to the eyelids and ocular surface of each patient during the first 10 days of illness. Repeat AMT was performed every 10-14 days as long as severe ocular surface inflammation and epithelial sloughing persisted.

Main outcome measures: Visual acuity, dry eye severity, and scarring of the ocular surface and eyelids were assessed after a follow-up of ≥6 months.

Results: All patients had best-corrected visual acuity of ≥20/30, with 9 of the 10 seeing 20/20. Dry eye severity was moderate or less in all patients. Overall ocular surface and eyelid scarring was mild to moderate in all patients.

Conclusions: In acute SJS and TEN, AMT is an effective treatment for severe ocular surface and eyelid inflammation, greatly decreasing the risk of significant ocular and visual sequelae.