Stevens-Johnson syndrome (SJS), related to toxic epidermal necrolysis (TEN) conditions, often affects the mucous membranes, including the eyes. Ocular surface manifestations can include bullae, conjunctival injections and epithelial defect.1 Typical treatments range from topical corticosteroids and antibiotics to amniotic membrane grafts.1

In a recent study, researchers investigated the outcomes of eyes with chronic SJS sequelae that were treated with a novel procedure, cultivated oral mucosal epithelial transplantation (COMET). The prospective, interventional case series included 45 eyes of 41 patients with chronic SJS sequelae who were evaluated between 2013 and 2017. All patients underwent COMET for fornix reconstruction and visual rehabilitation, with documented follow-up for up to two years.

Patients’ mean visual acuity improved from 2.7±0.5 logMAR to 1.5±0.7 logMAR and 1.49±0.98 logMAR, at one and two years postoperatively. The researchers noted that 37 eyes had visual acuity improvements, six experienced no change and two had worsening of visual acuity. Still, ocular surface severity scores improved overall, from 29.1±9.7 to 18.7±7.2, postoperatively. Two eyes developed persistent epithelial defects that progressed to corneal melt and required keratoplasty.

The researchers concluded that “COMET allows for successful and sustained restoration of the ocular surface anatomy with functional improvement in eyes with chronic sequelae of SJS.”

1. Wang JW, Rixen JJ, Goins KM, et al. Ocular manifestations of Stevens-Johnson syndrome: 13-year-old female with mucosal and dermatologic eruptions. Ophthalmology and Vis Sci. August 18, 2014. [Epub].

2. Venugopal R, Nagpal R, Mohanty S, et al. Outcomes of cultivated oral mucosal epithelial transplantation in eyes with chronic Stevens-Johnson Syndrome sequelae. Am J Ophthalmology. August 18, 2020. [Epub ahead of print].