Mucous Membrane Grafting For Lid Margin Keratinization in Stevens-Johnson Syndrome: Results

Purpose: To study the efficacy of mucous membrane grafting as a surgical technique to address lid margin keratinization, an important cause for chronic blink-related microtrauma in Stevens-Johnson syndrome (SJS). Methods: The keratinized strip of conjunctiva along the lid margin was excised and replaced by lip mucous membrane using fibrin glue in 54 eyes of 31 patients with lid margin keratinization after SJS. This was a retrospective case series carried out between April 2005 and November 2006. Results: In 50 of 54 eyes (92.6%), there was improvement or stabilization in patient comfort, conjunctival hyperemia, ocular surface staining characteristics, and best-corrected visual acuity over a mean follow-up period of 6 months. Conclusions: The authors describe the method of mucous membrane grafting for addressing lid margin keratinization, one of the important causes for persistent inflammation in SJS. This procedure not only improves patient comfort and visual acuity by reducing surface inflammation but also possibly prevents further deterioration of ocular surface in SJS.