Early Amniotic Membrane Transplantation (AMT) in the management of a paediatric patient with toxic epidermal necrolysis

Abstract

PURPOSE: To report the ocular and visual outcomes after AMT in the management of a paediatric patient with TEN. METHODS: A 15 year-old girl was transferred to the intensive care unit of Queen Mary Hospital with TEN after taking oral cefuroxime and diclofenac. She developed bilateral keratoconjunctivitis, diffuse corneal epithelial defects (80-90%) and bilateral symblepharon. After daily rodding, topical lubricants, steroids and antibiotics, there was no improvement in her condition. Bilateral amniotic membrane transplantation (AMT) was performed over cornea, fornix, tarsal and bulbar conjunctiva on the tenth day of illness. RESULTS: At post-op week 7, the patient had pinhole visual acuity of 20/25 in the right eye and 20/20 in the left eye. She was eventually weaned off all topical medication. There was mild residual ocular surface and eyelid scarring. CONCLUSION: Early use of AMT minimized ocular damage in a patient with severe ocular surface inflammation secondary to TEN.