HARD-PALATE MUCOSA GRAFT IN STEVENS-JOHNSON SYNDROME

PURPOSE: We evaluated the use of hard-palate mucosa grafts in the trea tment of cicatricial entropion and trichiasis associated with Stevens- Johnson syndrome. METHODS: Six patients, two men and four women, were treated with hard-palate mucosa grafts of one or more eyelids with cic atricial entropion, trichiasis, and corneal disease. The follow-up ran ged from 19 to 33 months. RESULTS: Visual acuity improved in one of ni ne eyes and remained stable in the rest. Corneal epithelial disease im proved in eight of nine eyes, while in one eye the epithelial defect s tabilized. The corneal epithelium of all three corneal transplants rem ained intact, although one of these patients underwent another corneal transplantation and the other two transplants opacified from rejectio n. cicatricial entropion resolved and symblephara improved in all 16 e yelids. Trichiasis resolved or improved in 12 of 16 eyelids and remain ed stable in the other eyelids. CONCLUSIONS: The chronic relapsing nat ure of Stevens-Johnson syndrome requires caution in interpreting surgi cal intervention in the treatment of dysfunctional eyelids. However, h ard-palate grafts may be considered for patients with the Stevens-John son syndrome and severe ocular surface disease.