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Cataract surgery in chronic Stevens–Johnson syndrome: aspects and outcomes
  1. Purvasha Narang1,
  2. Ashik Mohamed2,
  3. Vikas Mittal3,
  4. Virender S Sangwan1
  1. 1Tej Kohli Cornea Institute, L V Prasad Eye Institute, Hyderabad, India
  2. 2Prof. Brien Holden Eye Research Centre, L V Prasad Eye Institute, Hyderabad, India
  3. 3Cornea and Anterior Segment Services, Sanjivni Eye Care, Ambala City, India
  1. Correspondence to Dr Virender S Sangwan, Tej Kohli Cornea Institute, L V Prasad Eye Institute, L V Prasad Marg, Banjara Hills, Hyderabad 500034, Telangana, India; vsangwan{at}lvpei.org

Abstract

Aim To assess the outcome of cataract surgery in patients with chronic sequelae of Stevens–Johnson syndrome (SJS).

Methods Setting: Tertiary eye care centre in South India. Design: Retrospective, non-comparative, consecutive, interventional case series. Study period: March 2003 to May 2014. Of the 1662 consecutive patients with SJS, 32 patients (40 eyes) with chronic sequelae of SJS who underwent cataract surgery were included. The main outcome measures were best-corrected visual acuity (BCVA) and ocular surface stabilisation. The visual acuity was expressed with reference to the logMAR.

Results The study included 12 men (37.5%) and 20 women (62.5%). 8 patients (25%) had bilateral cataract surgeries. The median preoperative BCVA was 1.61 (IQR, 0.80 to 2.78) (only perception of light in three eyes). The median BCVA in the immediate postoperative period was 0.60 (IQR, 0.30 to 1.48) (perception of light in an eye) which was significantly different from the preoperative BCVA (p<0.0001). The median BCVA achieved was 0.30 (IQR, 0.00 to 0.80), suggesting further improvement. Median time taken to achieve this postoperatively was 1.5 months (IQR, 8 days to 3 months). The median BCVA during the last follow-up was 0.48 (IQR, 0.18 to 1.00). The preferred type of cataract surgery was phacoemulsification. Ocular surface condition remained stable in 35 eyes (87.5%). Ocular surface breakdown in four eyes (10%) was managed appropriately.

Conclusion Cataract surgery outcome can be visually rewarding in chronic sequelae of SJS provided ocular surface integrity is adequately maintained preoperatively and postoperatively.

  • Inflammation
  • Ocular surface
  • Treatment Surgery

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Footnotes

  • Twitter Follow Ashik Mohamed at @mducityman

  • Contributors Design and conduct of the study: VSS; collection, management, analysis and interpretation of the data: PN, AM and VM; preparation of the manuscript: PN; review of the manuscript: AM, VM and VSS; final approval of the manuscript: PN, AM, VM and VSS.

  • Competing interests None declared.

  • Ethics approval Institutional Review Board, L V Prasad Eye Institute, Hyderabad, India.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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