symblepharon ocular surgery

INTRODUCTION: This study analysed the causative factors and clinical characteristics of acute and chronic ocular sequelae of Stevens-Johnson syndrome and toxic epidermal necrolysis (SJS/TEN) treated at a large third-referral centre in a developed country (Hungary) over a 15-year period. METHODS: This was a retrospective review of patients with acute and/or chronic SJS/TEN who were managed between 2006 and 2020 at the Department of Ophthalmology of Semmelweis University in Budapest, Hungary...

INTRODUCTION: Prolonged exposure to a complete button battery can cause severe tissue necrosis in the eye and permanent impairment of visual function. The main mechanism of injury is the current generated by the hydrolysis of tissue fluid at the negative electrode and the production of hydroxide ions. CASE PRESENTATION: A 3-year-old girl went to the local hospital because of swelling and pain in her right eye of 12-h duration. The local doctor performed an orbital CT (computed tomography) scan and found a foreign body between the right eyelid and the eyeball...

PURPOSE: To provide the long-term outcome of patients with end-stage severe ocular surface disease (OSD) consecutively treated with cultivated oral mucosal epithelial transplantation (COMET) followed by limbal-rigid contact lens (CL)-wear therapy. DESIGN: Retrospective cohort. METHODS: In 23 eyes of 18 patients with severe OSD who underwent COMET surgery between 2002 and 2019 and who were followed with limbal-rigid CL-wear therapy for at least 1 year postoperative, patient demographics, best-corrected visual acuity (BCVA, logMAR), Ocular Surface Grading Scores (OSGS), surgical indication and adverse events were reviewed...

PURPOSE: The purpose of this report was to describe a new alternative surgical technique combining oral mucosa and the Boston Keratoprosthesis type II (BKPro II) in a patient with severe chemical burn. METHODS: We present a case of a 37-year-old man who suffered a severe bilateral chemical burn. Visual acuity was light perception and projection in both eyes. After many surgeries, including eyelid reconstruction, eyelashes electrolysis, and amniotic membrane transplants, he presented a corneal thinning in his right eye that was managed with an autologous oral mucosa graft...

BACKGROUND: An improper procedure of esthetic lateral canthoplasty can lead to lateral canthal deformity with other complications. To ensure proper canthal contour and eyelid function, the lateral canthus must be restored and the lower eyelid must be stabilized. METHODS: This was a retrospective study that included a group of consecutive patients who had failed esthetical lateral canthoplasty between 2020 and 2022. All patients underwent the modified lateral tarsal strip procedure to restore the normal anatomy of the lateral canthus and stabilize the lower eyelid...

INTRODUCTION: We report the clinical outcome of a novel surgical technique called simple oral mucosal epithelial transplantation (SOMET) for the treatment of limbal stem cell deficiency (LSCD) in a patient with Stevens-Johnson Syndrome (SJS). PRESENTATION OF CASE: An eighteen-year-old girl was diagnosed as having chronic bilateral ocular sequelae of SJS. She initially underwent mucous membrane grafting (MMG) in both eyes for lid margin keratinization. Over the course of the next decade, the ocular surface cicatrization worsened in her left eye, leading to progressive symblepharon formation with total corneal conjunctivalization...

This prospective study aimed to evaluate the effectiveness of decellularized porcine conjunctiva (DPC) in the management of severe symblepharon. Sixteen patients with severe symblepharon were enrolled in this study. After symblepharon lysis and Mitomycin C (MMC) application, tarsus defects were covered with residual autologous conjunctiva (AC), autologous oral mucosa (AOM), or DPC throughout the fornix, and DPC was used for all the exposed sclera. The outcomes were classified as complete success, partial success, or failure...

PURPOSE: Evaluation of the results of sutureless amniotic membrane transplantation (AMT) using a pediatric nasogastric tube (NGT) for patients with acute Stevens-Johnson syndrome/toxic epidermal necrolysis (SJS/TEN) was aimed. METHODS: Twenty-six eyes of 13 patients with SJS/TEN with ocular involvement at a single tertiary care hospital between May 2020 and January 2022 were included in the study. An amniotic membrane was implanted to the ocular surface and conjunctival fornix using a modified symblepharon ring (MR) created by inserting NGT end-to-end...

INTRODUCTION: Toxic epidermal necrolysis (TEN), also known as Steven Johnson syndrome (SJS), is a devastating disease. Patients develop blindness and symblepharon despite multiple reconstructive surgeries. We report a case of SJS/TEN with ocular involvement where treatment with hyperbaric oxygen therapy (HBOT) resulted in a significant improvement in the visual acuity after surgery. CASE PRESENTATION: A woman with SJS/TEN with severe ocular complication (SOC) had limbal stem cell deficiency and symblepharon of the superior and inferior fornix...

(1) Background: This study aimed to evaluate the clinical outcome of Sandwich (Amnion/Conjunctival-Limbal Autograft/Amnion) transplantation for recurrent pterygium with restrictive strabismus. (2) Methods: This retrospective study included 11 eyes in 11 patients diagnosed with recurrent pterygium with restrictive strabismus who received sandwich transplantation. The outcomes were measured by pterygium recurrence, best-corrected visual acuity, esotropia (prism diopters), and treatment complications. (3) Results: Eleven patients (six males, five females) had a mean age of 60...

Purpose: To describe the case of a monocular patient with ocular mucous membrane pemphigoid (MMP) and open angle glaucoma refractory to medical treatment, who was successfully managed with ab interno goniotomy at the time of cataract surgery. Methods: A 63-year-old woman with a history of severe MMP presented with exacerbation of the disease in both eyes. Vision was 20/80 in the right eye and light perception in the left eye. Symblepharon formation, trichiasis and forniceal foreshortening were present in the right eye, while the cornea of the left eye was completely conjunctivalized...

PURPOSE: To report the occurrence and the outcomes of 2 cases of spontaneous extrusion of 3-piece intraocular lens (IOL) through a Gundersen conjunctival flap performed for tectonic purposes after multiple failed penetrating keratoplasties (PKs). METHODS: A 70-year-old woman (Patient #1) with severe dry eye disease who had undergone cataract surgery with posterior chamber 3-piece IOL implantation, multiple PKs and Gundersen conjunctival flap in her left eye presented with partial extrusion of the optic and the inferior haptic of the IOL through the conjunctival flap...

BACKGROUND: Ocular surface burns can be caused by chemicals (alkalis and acids) or direct heat. One effect of the burn is damage to the limbal epithelial stem cells of the ocular surface with delayed re-epithelialisation, stem cell failure, and conjunctivalisation of the cornea. Amniotic membrane transplantation (AMT) performed in the acute phase (day 0 to day 7) following an ocular surface burn is claimed to reduce pain and accelerate healing. The surgery involves securing a layer of amniotic membrane (AM) to the eyelid margins as a patch to cover the entire ocular surface...

Of the various manifestations of ocular chemical burns (OCBs), ischemia of the limbus and the peri-limbal sclera indicates poor prognosis and in severe cases threaten the integrity of the globe. Tenonplasty is a surgical procedure which involves advancing the Tenon's capsule over the ischemic areas to provide a vascular supply and to enable migration of the conjunctival epithelium. This review aims to provide an overview of the diagnosis of limbal ischemia and its management with Tenonplasty. A literature review was conducted using the keywords "Tenonplasty," "Tenon's capsule," "ocular chemical injury," "ocular thermal injury," "Tenon advancement," "scleral ischemia," and "limbal ischemia," and outcomes were studied from seven selected articles...

OBJECTIVE: To evaluate the midterm results of tumour resection with or without adjunctive therapy for ocular surface squamous neoplasia of the fornix, including conjunctival reconstruction with buccal mucosa and amniotic membrane. METHODS: A retrospective case-series analysis including slit-lamp examination, photographic documentation, and biopsy results (repeated when clinical findings changed). Analysis centred on eye function, complications, additional procedures, and recurrence rate...

PURPOSE: Assessment of ocular surface in patients using anti-glaucoma medications (AGM) is rarely a priority for clinicians since glaucoma management targets intraocular pressure and preserves vision. This review summarizes the various adverse effects of topical AGM on the ocular surface and highlights the importance of ocular surface assessment in these patients. METHODS: A literature search of articles (English only) on the subject matter was conducted focusing on recent articles published in the past 5 years...

Recently, the prescription of large-diameter rigid gas-permeable contact lenses (CLs), also known as "scleral lenses," "corneoscleral lenses," and "limbal-rigid CLs," is on the rise for the treatment of both moderate and severe ocular surface disorders (OSDs). Compared with scleral lenses, the diameter of limbal-rigid CLs is generally smaller, that is, a diameter ranging from 13.0 to 14.0 mm, and they are designed so that the peripheral edge bears on the limbus. The Suncon Kyoto-CS (Sun Contact Lens Co., Ltd...

Objective: To observe the outcomes of cataract surgery in ocular cicatricial pemphigoid (OCP) patients and explore routine perioperative medical treatments. Design: Retrospective case series. Methods: Fourteen eyes of 8 patients were included in the study. Foster's stage 1-4 OCP patients were given human intravenous immunoglobulin, whereas patients with active inflammation were treated with prednisone tablets and methotrexate. Those who were intolerant to methotrexate and had severe inflammatory symptoms were treated with cyclophosphamide...

PURPOSE: To describe the challenges of surgically treating Stevens-Johnson syndrome (SJS) cases with bilateral eyelid closure, a serious ocular sequela. OBSERVATIONS: This study involved two 69-year-old females, with subacute-stage SJS (Case 1 and Case 2), and a 37-year-old male with chronic-stage SJS (Case 3). Case 1 had undergone simultaneous bilateral symblepharon lysis at 4-months post SJS onset, and her logarithm of the minimum angle of resolution (logMAR) best-corrected visual acuity (VA) (BCVA) improved from 2...

PURPOSE: To evaluate the clinical outcomes of conjunctival autograft (CAG) versus simple limbal epithelial transplant (SLET) for management of unilateral partial limbal stem cell deficiency (LSCD). METHODS: This retrospective, comparative, interventional case series evaluated 30 eyes of 30 patients with unilateral partial LSCD. After corneal pannus dissection, 17 patients underwent CAG where graft was harvested from the ipsilateral or contralateral eye, while 13 patients underwent SLET where limbal biopsy was harvested from the contralateral eye...