Association of preoperative tear function with surgical outcome in severe Stevens-Johnson syndrome

Objective: To retrospectively study the surgical outcome in severe Stevens- Johnson syndrome (SJS). Design: Retrospective noncomparative case series. Participants: Twenty-nine eyes of patients with severe SJS associated with total conjunctivalization were examined. Intervention: Preserved human amniotic membrane grafting and keratolimbal a llograft transplantation was performed. Intensive immunosuppression and epi thelial management were continued postoperatively. Main Outcome Measures: Successful ocular surface reconstruction was determi ned by epithelialization with corneal epithelium. The association between s urgical outcome and preoperative tear function was studied. Results: The ocular surface was successfully covered by corneal epithelium in 13 eyes (44.8%), The mean corrected visual acuity recovered from 0.0039 to 0.017. Persistent epithelial defect was the most common complication. Ey es with successful ocular surface reconstruction had significantly better p reoperative Schirmer's test values (P = 0.025) and tear clearance rates (P = 0.043) than those that failed. Conclusions: In patients with severe SJS, preoperative tear function signif icantly influenced surgical outcome. Eyes with Schirmer's test value of >10 mm have a greater chance of successful ocular surface reconstruction. Opht halmology 2000;107:1518-1523 (C) 2000 by the American Academy of Ophthalmol ogy.