Available and affordable pre-definitive surgical management of symblepharon in end stage stevens johnson syndrome: a case report.

UNLABELLED: We describe an affordable, easily available technique to relieve discomfort, free the eyeball and partially rehabilitate a patient with ocular complications of end stage Stevens Johnson syndrome.

MATERIAL AND

METHODS

Two eyes of a patient with severe adhesions between the lids, bulbar conjunctiva and cornea were involved. After taking consent from patient, the adhesions were separated and the fornices were dressed with sofratulle and artificial lubricants until healing was complete.

DISCUSSION: The separation of the lids from the globe and prevention of contact between the ocular surface and tarsal conjunctiva until both are healed by sofratulle and lubricants happens to be the only choice in our environment without material and human resources for complex procedures such as submandibular autotransplantation, osteo-odonto keratoprosthesis and modified cutler beard flap. The use of amniotic membrane transplantation (AMT) was also not feasible at that time.

RESULTS

The visual acuity was hand movement in both eyes, the lids were free and the eyes remained freely mobile four weeks after surgery.

CONCLUSION

In an environment with little resources, our procedure is recommended for use as an initial procedure pending final rehabilitative surgery, as it is easily available and affordable.