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Case report
Oral mucous membrane grafts for total symblepharon and lid margin keratinisation post Stevens-Johnson syndrome

Abstract

A female patient in her late 40s presented with severe visual impairment and a history of oral ulcers, necrolysis of skin and hospitalisation after using gabapentin for neck pain 10 months ago. She was a diagnosed case of Stevens-Johnson syndrome (SJS) with chronic ocular sequelae—with total symblepharon and keratinised lid margins in the left eye and limbal stem cell deficiency and severe dryness in the right eye. Her visual acuity was perception of light in both eyes. She underwent left eye symblepharon release with autologous labial mucous membrane grafts (MMGs) for surface reconstruction and subsequent lid margin MMG for lid margin keratinisation. Best-corrected visual acuity improved to 20/25 with scleral lens in the left eye, which was sustained over 1 year of follow-up. Labial mucosa acts as a useful and easily accessible alternative to conjunctiva in eyes with bilateral severe ocular surface damage and total symblepharon secondary to SJS.

  • anterior chamber
  • oral and maxillofacial surgery

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