Amnion doughnut: a novel method for sutureless fixation of amniotic membrane to the bulbar and palpebral conjunctiva in acute ocular-involving Stevens-Johnson syndrome

羊膜环:一种用于急性眼部受累型史蒂文斯-约翰逊综合征中,将羊膜无缝线固定于球结膜和睑结膜的新方法

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Abstract

PURPOSE: The aim of this study was to describe a novel surgical method for the sutureless placement of amniotic membrane on the bulbar and palpebral conjunctiva in the setting of ocular-involving acute Stevens-Johnson syndrome. METHODS: Within 6 days of an acute Stevens-Johnson episode, a 27-year-old male developed early symblepharon, despite aggressive lubrication and topical steroid therapy. He underwent symblepharon lysis and placement of an amniotic membrane wrapped around a symblepharon ring. RESULTS: The patient maintained 20/20 vision in each eye with no recurrent symblepharon formation except for the temporal canthus (which was not covered with amniotic membrane). CONCLUSIONS: Symblepharon rings covered in amniotic membrane provide a sutureless way to fixate amniotic membrane to the bulbar and palpebral conjunctiva. This gave very good anatomic and functional outcomes in a patient with acute Stevens-Johnson syndrome. Future research could be directed toward the development of a symblepharon ring that will be able to better protect the far temporal conjunctiva.

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