Titre : | Case Report: Successful Corneal Crosslinking in a Patient with Corneal Ectasia Associated with Stevens-Johnson Syndrome |
Type de document : | article de périodique |
Auteurs : | Ye Li ; Lucy M. Lu ; Akilesh Gokul ; Mohammed Ziaei |
Année de publication : | 2021 |
Langues : | Français (fre) |
Descripteurs (mots clés) : | [Thésaurus Mesh]:S:Syndrome de Stevens-Johnson:Syndrome de Stevens-Johnson / thérapie [Thésaurus Mesh]Syndrome de Stevens-Johnson [Thésaurus Mesh]Transplantation de cornée [Thésaurus HELB]:Optique:réticulation de la cornée
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Résumé : | SIGNIFICANCE: Corneal ectasia can be a complication of Stevens-Johnson syndrome. When detected in a timely manner, corneal crosslinking can be a safe treatment. This is an important association to highlight that early diagnosis and treatment can prevent the need for invasive surgical procedures such as keratoplasty. PURPOSE: This study aimed to report a successful accelerated epithelium-off corneal crosslinking in a rare case of corneal ectasia secondary to Stevens-Johnson syndrome. CASE REPORT: A 25-year-old Indian man presented with a progressive visual acuity decline 5 years after an acute episode of Stevens-Johnson syndrome secondary to penicillin ingestion. Serial tomography scans confirmed the diagnosis of corneal ectasia. After the preparation of the ocular surface, which was deemed to have a mild degree of limbal stem cell deficiency, with frequent preservative-free lubrication and steroid use, accelerated epithelium-off crosslinking was performed with 4 minutes of continuous ultraviolet-A exposure at 30mW/cm2 and a total energy dose of 7.2J/cm2 . Complete re-epithelialization was observed at 72 hours after crosslinking with no complications. Corneal tomography 15 months after treatment showed stabilization of ectasia, with improvement in visual acuity. CONCLUSIONS: Corneal ectasia is a rare but important complication of Stevens-Johnson syndrome. Accelerated epithelium-off crosslinking treatment can be considered in patients with a compromised ocular surface after Stevens-Johnson syndrome. Pre-operative optimization of the ocular surface and vigilant monitoring in the early post-operative period are recommended for the prevention of complications. |
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