Technique of amniotic membrane transplant dressing in the management of acute Stevens-Johnson syndrome.

PURPOSE: To report the technique of amniotic membrane transplantation dressing during the acute phase of Stevens-Johnson syndrome. METHODS: Interventional case report. We report the clinical presentation, surgical technique and clinical outcome of a patient with acute Stevens-Johnson syndrome and progressive tarsal conjunctival epithelial loss. RESULTS: A 10-year-old girl presented with extensive corneal, bulbar and tarsal conjunctival epithelial loss and severe ocular pain during the acute phase of Stevens-Johnson syndrome. Fornix cleaning and daily rodding was not tolerated, and there was no response to medical drug therapy. Emergency amniotic membrane transplant surgery was performed in both eyes. The conjunctival epithelium recovered completely and the ocular surface remained moist. There was almost complete resolution of ocular pain in the immediate postoperative period. There were no surgical complications and no signs of ocular cicatrisation after 6 months. CONCLUSIONS: In the acute phase of severe Stevens-Johnson syndrome, conservative measures of daily fornix cleaning and rodding may not be practical. AMT dressing may be successfully used to reduce ocular inflammation, promote epithelialisation and prevent ocular cicatrisation.