The Dry Eye Zone

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Abstract: Salivary gland transplantation for severe dry eye from chemical burns and SJS

Labial salivary gland transplantation for severe dry eye due to chemical burns and Stevens-Johnson syndrome.
Ophthal Plast Reconstr Surg. 2010 May-Jun;26(3):182-4.
Marinho DR, Burmann TG, Kwitko S.
Department of Ophthalmology, Hospital de Clínicas de Porto Alegre, Federal University of RGS, Porto Alegre, Brazil. diane@portoweb.com.br

PURPOSE: Salivary gland transplantation has been a promising alternative for the treatment of dry eye syndrome. In this article, we describe the results of an autotransplant procedure of labial salivary glands in the upper conjunctival fornix of patients with severe dry eye.

METHODS: A total of 14 eyes from 14 patients presenting with Stevens-Johnson syndrome and chemical burns were prospectively analyzed after surgery (average follow-up of 14 months). We evaluated their underlying symptoms, visual acuity, biomicroscopy, Schirmer's test, break-up time, and need for lubricants before and after transplantation.

RESULTS: All patients expressed improvement in their ocular discomfort. Nine eyes showed a slight best-corrected visual acuity improvement, while the vision of the remainder stayed stable. Corneal staining, present in all patients before surgery, was persistent in only four patients, but in a reduced area. Schirmer's test and break-up time showed significant increase in all patients (p < 0.05). In 71% of the patients, the use of lubricants was reduced.

CONCLUSION: Labial salivary gland transplantation can improve the life quality of patients with compromised ocular surfaces who suffer from severe dry eye syndrome.
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