Vision-related function after scleral lens fitting in ocular complications of Stevens-Johnson syndrome and toxic epidermal necrolysis.
OBJECTIVE
To describe the therapeutic benefits of scleral lenses in the management of severe ocular surface disease attributable to toxic epidermal necrolysis (TEN) and Stevens-Johnson syndrome (SJS).


METHODS
Retrospective study.


METHODS
Clinical records of 39 patients (67 eyes) fitted with scleral lenses for refractory ocular surface disease attributable to SJS or TEN were reviewed. To assess vision-specific quality of life, each patient completed the Ocular Surface Disease Index (OSDI) questionnaire and the National Eye Institute Visual Function Questionnaire (NEI VFQ-25). Slit-lamp examination was performed at regular intervals to detect side effects. Main outcome measures were best-corrected visual acuity (VA) and OSDI and NEI VFQ-25 composite score before and 6 months after scleral lens fitting.


RESULTS
The mean age was 35.8 +/- 13.9 years. Scleral lens fitting failed in 3 patients. The mean follow-up was 33.3 +/- 17.6 months. Among fitted patients, VA in the better eye (36 patients, 36 eyes) progressed from 0.73 to 0.50 logarithm of the minimum angle of resolution (P = .0001) 6 months after scleral lens placement. The mean OSDI improved from 76.9 +/- 22.8 to 37.1 +/- 26.7 (P = .0001). Thirty-two NEI VFQ-25 composite scores were available. The mean NEI VFQ-25 composite score improved from 25.1 +/- 16.8 to 67.4 +/- 22.1 (P = .0001). No serious adverse events attributable to the scleral lenses occurred.


CONCLUSIONS
Scleral lens use appears to be efficient and safe for visual rehabilitation of refractory ocular surface disease attributable to TEN and SJS.
Tougeron-Brousseau
Bénédicte
B
Ophthalmology Department, Charles Nicolle Hospital, CHU de Rouen, Rouen, France.
Delcampe
Agnès
A
Gueudry
Julie
J
Vera
Lisa
L
Doan
Serge
S
Hoang-Xuan
Thanh
T
Muraine
Marc
M
D000293:Adolescent; D000328:Adult; D000368:Aged; D002648:Child; D003229:Conjunctival Diseases / Q000209:etiology / Q000503:physiopathology / Q000628:therapy*; D003261:Contact Lenses; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D017755:Prosthesis Fitting; D011788:Quality of Life; D012189:Retrospective Studies; D018434:Sickness Impact Profile; D013262:Stevens-Johnson Syndrome / Q000150:complications / Q000503:physiopathology / Q000628:therapy*; D011795:Surveys and Questionnaires; D014786:Vision Disorders / Q000209:etiology / Q000503:physiopathology*; D014792:Visual Acuity / Q000502:physiology*; D055815:Young Adult