Lid-Related Keratopathy in Stevens-Johnson Syndrome: Natural
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Highlights:
-Vision in eyes with lid-related keratopathy after SJS/TEN deteriorates over time.

-Both MMG and PROSE preserve and improve vision over the long-term.

-MMG is more effective than PROSE in children.

-PROSE is more effective than MMG in adults.

-MMG and PROSE used together provide the best results both in children and adults.

Stevens-Johnson syndrome (SJS) is a blistering auto-immune disease affecting the skin and mucous membranes. SJS and its more severe form, toxic epidermal necrolysis (TEN), can involve the eyes in 40-84% cases in the acute phase,2, 3, 4, 5, 6 and unfortunately 43-89% progress to suffer from long-term ocular complications. A study was conducted to compare the long-term visual outcomes of different management strategies in children and adults with Stevens-Johnson Syndrome (SJS)-induced chronic lid-related keratopathy . study included 705 eyes of 401 patients (81 children and 320 adults) with SJS who presented with chronic lid-related keratopathy

The treatment sub-groups were comparable at baseline in terms of BCVA and prior management. Over a period of 10 years, children and adults receiving conservative therapy lost at least 5 lines of median BCVA and carried a 3-times higher risk of developing corneal ulceration in the first year. Conversely, definitive therapy provided significant benefit by improving median BCVA. In children, MMG was more effective than PROSE, while PROSE was more effective than MMG in adults. However, the combination of MMG followed by PROSE provided the best results in both children and adults.

Both MMG and PROSE changed the natural course and helped in preserving and improving vision in eyes with SJS-induced lid-related keratopathy. Irrespective of age, those receiving both MMG and PROSE had the best long-term visual outcomes.

Source: https://www.ajo.com/article/S0002-9394(20)30357-3/fulltext?rss=yes
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