Sutureless amniotic membrane transplantation with cyanoacrylate glue for acute Stevens-Johnson syndrome/toxic epidermal necrolysis
Sutureless amniotic membrane transplantation with cyanoacrylate glue for acute Stevens-Johnson syndrome/toxic epidermal necrolysis
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DOI：
10.1016/j.jtos.2019.03.001
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发表时间：
2019-07-01
期刊：
影响因子：
6.4
通讯作者：
Saeed, Hajirah N.
中科院分区：
文献类型：
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作者：
Shanbhag, Swapna S.;Chodosh, James;Saeed, Hajirah N.
在Stevens-Johnson综合征(SJS)/中毒性表皮坏死松解症（TEN）患者的急性期进行羊膜（AM）移植，已知可减少慢性期眼部并发症的发病率。在SJS/TEN等情况下，AM需要固定在眼表和眼睑上。以前，在SJS/TEN的急性期，已经描述了用纤维蛋白胶将大片AM固定在眼表上，并用缝合线和支架固定在眼睑上的技术。这些技术通常需要在急症患者中使用手术室。我们描述了一种床边技术，使用氰基丙烯酸酯胶将AM固定在眼睑上，以及4例急性SJS/TEN患者的长期结果。在整个眼表上固定AM的定制睑环和将AM固定在眼睑边缘的氰基丙烯酸酯胶的结合是快速、无痛的，不需要局部或全身麻醉，并且可能在其他先前显示的受益于AMT的情况下被证明是有用的，比如眼部化学损伤。
Amniotic membrane (AM) transplantation, when performed in the acute phase in Stevens-Johnson syndrome (SJS)/toxic epidermal necrolysis (TEN) for patients with ocular complications, is known to reduce the morbidity of ocular complications in the chronic phase. In conditions such as SJS/TEN, AM needs to be secured to the ocular surface as well as the eyelids. Previously, techniques of securing a large sheet of AM with fibrin glue to the ocular surface and with sutures and bolsters to the eyelids have been described in the acute phase of SJS/TEN. These techniques often necessitate the use of an operating room in acutely ill patients. We describe a bedside technique that uses cyanoacrylate glue to secure the AM to the eyelids, as well as long-term outcomes in 4 patients with acute SJS/TEN. The combination of a custom symblepharon ring to secure AM over the entire ocular surface and cyanoacrylate glue to secure AM to the eyelid margins is quick, painless, does not require local or general anesthesia, and might prove useful in other conditions previously shown to benefit from AMT, such as ocular chemical injuries.