Simple limbal epithelial transplantation for refractory epithelial defects in acute ocular toxic epidermal necrolysis: A case report

To describe the use of simplified limbal epithelial transplantation (SLET) from a cadaver donor for managing a refractory epithelial defect in the acute phase of severe toxic epidermal necrolysis (TEN) in a pediatric patient. A child with severe acute TEN presented with bilateral conjunctival hyperemia, conjunctival membranes, epithelial keratitis, corneal epithelial defects, and eyelid margin ulceration. Standard treatment included lysis of adhesions, removal of conjunctival membranes, and ocular surface coverage with an amniotic membrane. Due to its persistent refractory epithelial defects, SLET was performed on the more severely affected eye. The eye treated with cadaveric donor SLET achieved complete epithelialization earlier than the contralateral eye, which received only the standard treatment. SLET using cadaveric donor tissue can be an effective intervention for managing refractory epithelial defects during the acute phase of severe TEN, particularly in cases where standard therapies are insufficient.