[Transplantation of labial salivary glands for severe dry eye treatment]

Arq Bras Oftalmol. Jul-Aug 2005;68(4):481-9. doi: 10.1590/s0004-27492005000400012. Epub 2005 Nov 22.
[Article in Portuguese]

Abstract

Purpose: To study the clinical effects of the secretion of transplanted labial glands used as ocular lubricant to treat severe dry-eye cases, to evaluate the duration of the results and to simplify the surgical technique.

Methods: Thirty-seven surgeries were performed in twenty-one patients during the period of July 2000 to January 2004. The graft, consisting of labial mucosa and underlying salivary glands, was transplanted to the previously prepared area in the conjunctival fornix. All procedures were recommended in severe dry-eye cases, that is, eyes with total or nearly total xerophthalmia. The preoperative and postoperative protocols are presented emphasizing the items which were used in the comparative analysis of the results as well as the technical description of the surgical procedure.

Results: The graft survival and integration into the host tissues were observed in 97.2% of the cases. The clinical improvement, demonstrated by the disappearance of the symptoms, better biomicroscopic aspect of the ocular surface, better vision and disuse of lubricant drops, was observed in 91.9% of the cases. The follow-up showed not only persistence but also stability of the results. Infection represented one case and ptosis represented three cases of the only four observed complications.

Conclusion: The improvement of severe dry-eye cases detected after the transplantation of labial salivary glands is significant. It demonstrates that the lubricant ocular surface produced by the salivary secretion is efficient and well-tolerated. The follow-up shows that the result persists in the long term from which it is concluded that the production of the secretion is permanent. The surgical technique of transplanting the labial salivary gland to the conjunctival fornix is very simple and easily accessible to any ophthalmic surgeon.

MeSH terms

  • Conjunctiva / surgery
  • Humans
  • Keratoconjunctivitis Sicca / etiology
  • Keratoconjunctivitis Sicca / surgery*
  • Lacrimal Apparatus / surgery
  • Mouth Mucosa / transplantation*
  • Preoperative Care
  • Saliva / metabolism*
  • Salivary Glands, Minor / transplantation*
  • Stevens-Johnson Syndrome / complications
  • Transplantation, Autologous
  • Treatment Outcome
  • Xerophthalmia / etiology
  • Xerophthalmia / surgery*