Challenges in managing Steven Johnson Syndrome with chronic ocular and extraocular abnormality.

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Joshua Lumbantobing
Yunia Irawati

Abstract

Background: Stevens-Johnson syndrome (SJS) is one of the most debilitating adverse drug reactions which can lead to ocular complications, making management more challenging with multiple options for surgical approaches.


Case report: A 10-year-old girl with a history of SJS presented with difficulty opening both eyes after a symblepharon release surgery twice in other hospital. Unfortunately, there was still recurrence of symblepharon in both eyes followed with trichiasis and entropion. The multistep surgical approaches for ocular restoration were symblepharon lysis surgery, followed by amnion membrane transplant and conformer shell placement on both eyes. The shells were released one month after the initial surgery. After being treated for several months, the patient underwent eyelid reconstruction surgery for trichiasis and entropion to provide better ocular surface. Nevertheless, these approaches still showed recurrence of symblepharon in the left eye 6 months after the initial surgery.


Conclusion: Surgical approach should be patient-tailored based on complexity and severity of the ocular complications of SJS. Comprehensive management in treating SJS is required since the presence of systemic processes and complications are always possible.


Conflict of interest: none.

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References

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