Editor: When I first started learning about the contraindications to conventional corneal transplantation, [Stevens-Johnson syndrome] caught my eye with its unique name. So I began my long journey of discovery with curiosity about it, and finally discovered these untold secrets...
What is Stevens-Johnson syndrome?
Stevens-Johnson syndrome (SJS), first reported by Stevens and Johnson4 in 1922, is a rare and severe acute non-purulent cutaneous mucosal syndrome that manifests as a dark or dark red target rash dominated by the face and trunk with severe mucosal damage to the eyes, mouth, vulva, and often with persistent fever, lymphadenopathy, hepatitis hepatitis, cytopenia, and other systemic damage.
Mich Medical once received a female patient who was blind due to Stevens-Johnson syndrome, and due to the necrosis of the conjunctiva and surface tissues, her stem cells at the corneal margin and conjunctiva suffered severe damage, and eventually the conjunctivation of the whole cornea occurred, and the entire cornea was covered by the neovascular membrane and lost its transparency. According to her own words, she was going to give up treatment, but she overheard about Mich and wanted to try it, but she didn't expect the operation to be successful.
Artificial corneal transplant surgery is the only hope of restoration
In fact, there are not a few patients like her in China. About 15% of the more than 4 million corneal blind patients in mainland China have difficulty in routine corneal transplantation, perhaps patients with severe eye burns (chemical burns, thermal burns), patients who have failed multiple routine corneal transplants, or stevens-Johnson syndrome as described in this article.
For these high-risk corneal transplant patients, artificial corneal transplant surgery is the only hope of regaining sight.
An artificial cornea is implanted in the eye
In the past two years, the domestic artificial cornea has developed rapidly. Domestic collar-button type artificial cornea and Mich artificial cornea have been listed successively. Unfortunately, the latch-down artificial cornea is not indicated for patients with Stevens-Johnson syndrome, including corneal opacification with a large number of neovascularizations, congenital iris animism, severe eye burns, and patients with severe Sjögren syndrome.
Image source Chinese Expert Consensus on Corneal Transplant Surgery (2021)
The official documents show that the mich artificial cornea is suitable for patients with binocular blindness who are difficult to succeed in corneal transplant surgery, including corneal transplant failure, chemical injury, heat burn, explosion injury and other serious corneal scar vascularization, eyelid atresia, serious autoimmune diseases (such as Steven-Johnoson syndrome and scar pemphigoid), corneal blindness caused by terminal dry eyes, etc.
This suggests that patients with contraindications to many other products, including Steven-Johnoson syndrome, can be re-enlightened through the Mich artificial cornea.
In addition, Mich Medical has continued to innovate in artificial cornea research and development technology for 24 years, creating a precedent of "no need for living cornea", solving the problems of lack of corneal donors and corneal transplant rejection, and actively carrying out artificial corneal transplant surgery in cooperation with well-known hospitals in China, obtaining good clinical results and accumulating a large amount of clinical experience.
Find the right product, treat it as soon as possible, and do a good prognosis
Typically, toxic epidermal necrolysis of Stevens-Johnson syndrome is more damaging to the whole body, and its complications may be lifelong. In order to further alleviate the damage to vision of the disease, the most important thing is to prevent the emergence of complications.
Therefore, a detailed examination of the eye early in the skin lesions is very necessary. At the same time, serious complications such as trichiasis, corneal epithelial disorders, and secondary infections should be taken into account. In short, if you are blind because of Stevens-Johnson syndrome, you need to do three steps: find the right product; treat it as soon as possible; and do a good prognosis.
This article refers to a case of blindness caused by Stevens-Johnson syndrome in children
Tang Xuhua, Zhou Hui, Zhong Minhua, Cao Guangling, Gao Qian
(Department of Dermatology, First Affiliated Hospital of Sun Yat-sen University, Guangzhou, Guangdong 510080)