Surgical Treatment of the Ophthalmological Complications in Lyell’s Syndrome. A Clinical Case
https://doi.org/10.18008/1816-5095-2026-2-388-395
Abstract
Lyell’s syndrome is a severe toxic allergic reaction that occurs in 0.3 % of cases of drug allergies. Currently, Lyell’s syndrome is considered as a proteolytic reaction with damage to the skin and mucous membranes. A clinical case of treating a patient with ophthalmic complications of Lyell’s syndrome was described. During the illness and treatment of pneumonia, a corneal ulcer appeared with perforation in both eyes, which was not stopped by medical treatment. The patient underwent keratoplasty with a biological coating of the cornea according to Kunt and bloody blepharorrhaphy, which made it possible to stop the inflammatory process. The long-term effects of damage to the eyes that have undergone toxic epidermal necrolysis syndrome lead to severe cicatricial-dystrophic changes in the eyelids, conjunctiva and cornea, decreased vision, despite the fact that the intraocular media remained transparent and the retina was intact. The problem of rehabilitation of patients who have undergone toxic epidermal necrolysis is relevant. This article describes the treatment of the consequences of ocular damage in Lyell’s syndrome (elimination of symblepharon, eyelid inversion and trichiasis).
About the Author
I. V. Ivolgina
The Tambov branch of the S. Fyodorov Eye Microsurgery Federal State Institution
Russian Federation
Russian Federation
Ivolgina Irina V. - head of the Department
Rasskazovskoe highway, 1, Tambov, 392000
References
1. Laell A. Toxic epidermal necrolysis: an eruption resemling scalding of the skin. Br. J. Dermatol. 1956;68(11):355–361. doi: 10.1111/j.1365-2133.1956.tb12766.x.
2. Tan SK, Tay VK. Profile and Pattern of Stevens-Johnson Syndrome and Toxic Epidermal Necrolisis in a General Hospital in Singapore: Treatment outcomes. Acta Derm Venerol. 2012;92(1):62–66. doi: 10.2340/00015555-1169.
3. Mezhirova NM, Baeva SI, Azarokova AM. Features of the course and treatment of Lyell’s syndrome. Emergency medicine. 2011;5:36–38 (In Russ.).
4. Al’banova VI, Brunova OYu, Korsunskiy AA. Toxic epidermal necrolysis in a child. Russian journal of skin and venereal diseases. 2013;5:25–30 (In Russ.).
5. Grigor’ev DV. Erythema multiforme exudative, Stevens-Johnson syndrome and Lyell’s syndrome — a modern interpretation of the problem. Russian medical inquiry. 2013;22:1073–1083 (In Russ.).
6. Harr T, French LE. Toxic epidermal necrolysis and Stevens Johnson Syndrome. Orphanet J Rare Dis. 2010;5:39. doi: 10.1186/1750-1172-5-39.
7. Il’ina NI, Latysheva TV, Myasnikova TN, Luss LV, Kurbacheva OM, Erokhina SM. Drug allergy. Recommendations for clinicians (Part I). Russian journal of allergy. 2013;5:27–40 (In Russ.).
8. Vanichkin AA, Legeza GV, Dmitriev SK. Disturbances in immune status of patients at early period of eye burn disease. Ophthalmology journal. 1987;3:148–152 (In Russ.).
9. Varsheva II, Khashkina LA. Toxic epidermal necrolysis: clinical features and modern methods of treatment. Siberian scientific medical journal. 2014;129(6):130– 133 (In Russ.).
10. Gundorova RA, Bordogova GG, Tazetdinova NR. Surgical policy in the management of patients with post-burn changes of the eyelids, conjunctiva and cornea. Russian annals of ophthalmology. 1987;103(5):14–17 (In Russ.).
11. Zaykova MV. Plastic ophthalmosurgery. Moscow: Medicine; 1980:55–57 (In Russ.).
12. Oganesyan OG, Gundorova RA, Maychuk YuF, Makarov PV, Khoroshilova-Maslova IP, Ilatovskaya LV. New modification of autoconjunctival plastic repair in urgent surgery on the cornea. Russian annals of ophthalmology. 2002;1:18–22 (In Russ.).
13. Gundorova RA, Povolochko LI, Rzhechitskaya OV. Curative keratoplasty in various pathologic conditions of the cornea. Ophthalmology journal. 1983;258(2):75–77 (In Russ.).
14. Puchkovskaya NA. Curative keratoplasty and possibilities to stimulate regenerative property of the cornea. Ophthalmology journal. 1983;258(2):69–71 (In Russ.).
15. Gundorova RA, Bordyugova GG, Travkin AG. Reconstructive surgeries on the eyeball. Moscow: Medicine; 1983:223 (In Russ.).
16. Gundurova RA, Makarov PV, Dadasheva ZR. Dry eye syndrome treatment in burn eye disease. Ophthalmology in Belorussia. 2010;4(1):84–89 (In Russ.).
17. Yakimenko SA, Chalanova RI, Kolomiychuk SG. Some biochemical indices in dynamics of the eye burn and their significance. Ophthalmology journal. 2002;35–10 (In Russ.).
18. Nigmatullin RT. Essays on tissue transplantation. Ufa: Xerox STM; 2003:111–112 (In Russ.).
19. Puchkovskaya NA, Yakimenko SA, Nepomnyashchaya VM. Pathogenesis and treatment of eye burns. Moscow: Medicine, 2001:256 (In Russ.).
20. Puchkovskaya NA. Surgical treatment of extensive and total symblepharons. Russian annals of ophthalmology. 1951;30(4):6–13 (In Russ.).
21. Huang FM, Dong BS, Zhao JF. A conjunctival pulling-back technique for serious symblepharon. Zhonghua Zheng Xing Wai Ke Za Zhi. 2003;19(2):118–119.
22. Orth B, Press UP, Hubner H. Transplantation of autologous oral mucosa in the treatment of a symblepharon in Wegener’s disease — a case report. Klin Monatsbl Augenheilkd. 2001;218(7):514–517. doi: 10.1055/s-2001-16295.
23. Tyers AG. Colour Atlas of Ophthalmic Plastic Surgery. China; 2018:108–110.
24. Leatherbarrow B. Oculoplastic Surgery. New York: Trieme; 2019:132–135.
Review
For citations:
Ivolgina I.V. Surgical Treatment of the Ophthalmological Complications in Lyell’s Syndrome. A Clinical Case. Ophthalmology in Russia. 2026;23(2):388-395. (In Russ.) https://doi.org/10.18008/1816-5095-2026-2-388-395
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