title: Amnion doughnut: a novel method for sutureless fixation of amniotic membrane to the bulbar and palpebral conjunctiva in acute ocular-involving Stevens-Johnson syndrome.
abstract: OBJECTIVE
  The aim of this study was to describe a novel surgical method for the sutureless placement of amniotic membrane on the bulbar and palpebral conjunctiva in the setting of ocular-involving acute Stevens-Johnson syndrome.
  
  
  METHODS
  Within 6 days of an acute Stevens-Johnson episode, a 27-year-old male developed early symblepharon, despite aggressive lubrication and topical steroid therapy. He underwent symblepharon lysis and placement of an amniotic membrane wrapped around a symblepharon ring.
  
  
  RESULTS
  The patient maintained 20/20 vision in each eye with no recurrent symblepharon formation except for the temporal canthus (which was not covered with amniotic membrane).
  
  
  CONCLUSIONS
  Symblepharon rings covered in amniotic membrane provide a sutureless way to fixate amniotic membrane to the bulbar and palpebral conjunctiva. This gave very good anatomic and functional outcomes in a patient with acute Stevens-Johnson syndrome. Future research could be directed toward the development of a symblepharon ring that will be able to better protect the far temporal conjunctiva.
authors.affiliation: *Ruiz Department of Ophthalmology and Visual Science, The University of Texas Medical School at Houston, Houston, TX; and †Robert Cizik Eye Clinic, Houston, TX.
authors.forename: Christopher M
authors.initials: CM
authors.lastname: Pruet
authors.forename: Joanna H
authors.initials: JH
authors.lastname: Queen
authors.forename: Gene
authors.initials: G
authors.lastname: Kim
mesh_terms: D000208:Acute Disease; D000328:Adult; D000650:Amnion / Q000637:transplantation*; D003228:Conjunctiva / Q000601:surgery*; D006801:Humans; D008297:Male; D019736:Prostheses and Implants; D013262:Stevens-Johnson Syndrome / Q000601:surgery*; D013536:Suture Techniques; D014792:Visual Acuity