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
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DOI：
10.1007/s00417-014-2568-8
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发表时间：
2014-03-01
影响因子：
2.7
通讯作者：
Arumugam, Sumathi
中科院分区：
文献类型：
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作者：
Iyer, Geetha;Srinivasan, Bhaskar;Arumugam, Sumathi
史蒂文斯约翰逊综合征（SJS）可导致终末期角膜失明。本研究介绍了SJS眼部后遗症及并发症的综合治疗措施及效果。对232例SJS患者的464只眼进行手术干预（点状烧灼、眼睑缘角化黏液膜移植、穹窿重建术、构造术、角膜移植术和角膜假体）。这是一个非比较性、回顾性、干预性的病例系列。主要观察指标为最佳矫正视力（BCVA）的变化。次要结果测量包括角膜上皮荧光素染色和Schirmer's I条润湿所显示的眼表状态的改善。点状烧灼术（n = 160）和眼睑缘黏液膜移植术（n = 238）分别有70%和80%的眼BCVA和眼表状态改善或稳定。使用COMET （n = 6）进行穹窿重建手术后，50%的眼睛（n = 24）、63.9%的眼睛（n = 36）和81.8%的眼睛（n = 22）的眼睛BCVA得到改善。角膜假体手术后，72.34%的眼睛的BCVA达到千分之一日元20/200 （n = 47）。平均随访时间为53.3±15.2个月。史蒂文斯·约翰逊综合征的眼部后遗症可能会致盲。这些问题需要及早发现和处理，以延缓眼表的持续恶化。我们的研究旨在强调这一问题，以及在管理这种潜在致盲障碍方面采取综合措施的重要性。
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 a parts per thousand yen20/200 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.