Significant impact of cryopreserved amniotic membrane on acute ocular Stevens-Johnson syndrome and toxic epidermal necrolysis
The ocular surface is covered by an epithelium encompassing an area including the cornea, the limbus and the conjunctiva bordered by the upper and lower lids. The healthy state of the ocular surface epithelium depends on a stable and protective preocular tear film when the eye is open. A stable preocular tear film is governed by sound ocular surface defense that involves effective neuroanatomic integration of compositional and hydrodynamic factors by two neural reflexes (1). The compositional elements comprise the lacrimal gland, the meibomian gland, and the ocular surface epithelium to provide aqueous, lipid, and mucins in the tear fluid, respectively, whereas the hydrodynamic element includes effective eyelid-blinking-closure that also regulates tear evaporation, spread, and drainage (1,2). Dysfunction of any elements in the aforementioned neuroanatomic integration will result in ocular surface deficits that compromise the visual acuity.