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

Abstract

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. 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. 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). 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.