Labial salivary gland transplantation for severe dry eye due to chemical burns and Stevens-Johnson syndrome

Ophthalmic Plast Reconstr Surg. May-Jun 2010;26(3):182-4. doi: 10.1097/IOP.0b013e3181b8c3ad.

Abstract

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.

MeSH terms

  • Adult
  • Burns, Chemical / complications*
  • Conjunctiva / surgery*
  • Dry Eye Syndromes / etiology
  • Dry Eye Syndromes / surgery*
  • Eye Burns / chemically induced*
  • Female
  • Humans
  • Male
  • Middle Aged
  • Quality of Life
  • Salivary Glands / transplantation*
  • Stevens-Johnson Syndrome / complications*
  • Tears / physiology
  • Transplantation, Autologous
  • Visual Acuity / physiology