Amniotic membrane transplantation for SJS/TEN
Reviewed by Jonathan Chan

This is a retrospective study of consecutive patients who underwent amniotic membrane transplantation (AMT) in the acute stage of Stevens-Johnson syndrome (SJS) / toxic epidermal necrolysis (TEN) from Toronto, Canada, between 2009 and 2018 and had more than three months of follow-up included. Two surgical techniques were used, either by direct suturing of the AM on the ocular surface and use of bolsters or with the application of a custom symblepharon conformer. Postoperative medications include topical steroid eye drops, antibiotics and preservative-free artificial tears. Thirty-two eyes were included in the study, mean age was 27.2 +/-21.5 years (range: two months to 63 years), with seven patients younger than 18 years of age. At final follow-up, 21/32 (65%) of eyes had BCVA >/=20/40, seven (22%) eyes had 20/40 to 20/200, four (12%) had </=20/400. Paediatric patients had more conjunctival and lid abnormalities. Tarsal scarring in 12/14 (86%) and entropion in seven paediatric patients. Eyelid margin keratinisation (18/18 adult eyes,10/14 paediatric eyes). The authors advocate early AMT intervention to minimise ocular complications (between three to 10 days after initial presentation) and long-term follow-up care for these patients.C

Amniotic membrane transplantation (AMT) for Stevens-Johnson syndrome (SJS) / toxic epidermal necrolysis (TEN): the Toronto experience.
Yang Y, Fung SSM, Chew H, et al.
BRITISH JOURNAL OF OPHTHALMOLOGY
2021;105:1238-43.