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KMID : 0360220200610111358
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Journal of the Korean Ophthalmological Society
2020 Volume.61 No. 11 p.1358 ~ p.1363
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Lamellar Graft of an Acellular, Preserved Human Cornea for Recurrent Anterior Granuloma in Stevens-Johnson Syndrome
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Lee Seung-Hyeun
Bae Seon-Ha
Kim Kyoung-Woo
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Abstract
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Purpose: We describe a patient with Stevens-Johnson syndrome who exhibited recurrent anterior corneal granulomas after corneal perforation (despite multiple amniotic membrane [AM] transplantations); the patient was successfully treated by lamellar grafting of an acellular, preserved human cornea.
Case summary: Corneal granulomas developed four times in a 46-year-old man who had been diagnosed with Stevens-Johnson syndrome 17 years priorly and who had undergone multiple AM transplantations after corneal perforation. A corneal granulomatous mass recurred 2 months prior to presentation in our clinic; it rapidly increased in size. With the patient under general anesthesia, the corneal mass was excised and a 4.0-mm-diameter, acellular preserved human cornea (Halo; Eversight Inc., Palo Alto, CA, USA) was grafted. A similarly sized AM was placed over the grafted cornea. Although the engrafted cornea exhibited stromal infiltration 1 month after surgery, the keratitis improved following brief antibiotic treatment. At 8 months postoperatively, the wound was stable; no granuloma recurrence, no graft melting, and no suspected microbial keratitis were observed in the region of the graft.
Conclusions: In patients with Stevens-Johnson syndrome and recurrent anterior granulomas (despite multiple AM transplantations), a lamellar graft of acellular, preserved human cornea may be a good therapeutic choice.
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KEYWORD
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Corneal granuloma, Lamellar keratoplasty, Preserved cornea, Stevens-Johnson syndrome
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