Outcomes of Cultivated Oral Mucosal Epithelial Transplantation in Eyes With Chronic Stevens- Johnson Syndrome Sequelae

PURPOSE: To study the outcomes of cultivated oral mucosal epithelial transplantation (COMET) in eyes with chronic Stevens-Johnson syndrome (SJS) sequelae. DESIGN: Prospective interventional case series. METHODS: Forty-five eyes of 41 patients with chronic SJS sequelae were recruited and evaluated from 2013 to 2017 in an institutional setting. All patients underwent COMET, with an aim of fornix reconstruction and visual rehabilitation. Change in corrected distance visual acuity (CDVA), severity scores of various ocular surface param-eters, and the occurrence of complications were docu-mented during a follow up period of 2 years. Attainment and maintenance of a stable ocular surface, as assessed by change in the ocular surface severity scores was the primary outcome measure, while change in CDVA was the secondary outcome measure. RESULTS: The mean preoperative CDVA was 2.7 +/- 0.5 logMAR, which improved to 1.5 +/- 0.7 logMAR and 1.49 +/- 0.98 postoperatively, at 1-and 2-year follow-up visit. Overall, 82.2% eyes (37/45) had improvement in visual acuity, 13.3% (6/45) experienced no change, whereas 2 eyes (4.4%) had worsening of visual acuity. The total ocular surface severity scores improved from a mean preoperative value of 29.1 +/- 9.7 to 18.7 +/- 7.2 post-operatively, at 2-year follow-up. Two eyes developed persistent epithelial defects, with progression to corneal melting requiring keratoplasty. CONCLUSIONS: COMET allows successful and sus-tained restoration of ocular surface anatomy with func-tional improvement, in eyes with chronic sequelae of SJS.