Case Report: Successful Corneal Crosslinking in a Patient with Corneal Ectasia Associated with Stevens-Johnson Syndrome.
Optom Vis Sci
; 98(1): 13-17, 2021 01 01.
Article
in En
| MEDLINE
| ID: mdl-33394926
ABSTRACT
SIGNIFICANCE:
Corneal ectasia can be a complication of Stevens-Johnson syndrome. When detected in a timely manner, corneal crosslinking can be a safe treatment. This is an important association to highlight that early diagnosis and treatment can prevent the need for invasive surgical procedures such as keratoplasty.PURPOSE:
This study aimed to report a successful accelerated epithelium-off corneal crosslinking in a rare case of corneal ectasia secondary to Stevens-Johnson syndrome. CASE REPORT A 25-year-old Indian man presented with a progressive visual acuity decline 5 years after an acute episode of Stevens-Johnson syndrome secondary to penicillin ingestion. Serial tomography scans confirmed the diagnosis of corneal ectasia. After the preparation of the ocular surface, which was deemed to have a mild degree of limbal stem cell deficiency, with frequent preservative-free lubrication and steroid use, accelerated epithelium-off crosslinking was performed with 4 minutes of continuous ultraviolet-A exposure at 30 mW/cm2 and a total energy dose of 7.2 J/cm2. Complete re-epithelialization was observed at 72 hours after crosslinking with no complications. Corneal tomography 15 months after treatment showed stabilization of ectasia, with improvement in visual acuity.CONCLUSIONS:
Corneal ectasia is a rare but important complication of Stevens-Johnson syndrome. Accelerated epithelium-off crosslinking treatment can be considered in patients with a compromised ocular surface after Stevens-Johnson syndrome. Pre-operative optimization of the ocular surface and vigilant monitoring in the early post-operative period are recommended for the prevention of complications.
Full text:
1
Collection:
01-internacional
Database:
MEDLINE
Main subject:
Riboflavin
/
Stevens-Johnson Syndrome
/
Photosensitizing Agents
/
Corneal Diseases
/
Corneal Stroma
/
Cross-Linking Reagents
Type of study:
Diagnostic_studies
/
Etiology_studies
/
Risk_factors_studies
/
Screening_studies
Limits:
Adult
/
Humans
/
Male
Language:
En
Journal:
Optom Vis Sci
Journal subject:
OPTOMETRIA
Year:
2021
Type:
Article
Affiliation country:
New Zealand