Long-Term Follow-up after Submandibular Gland Transplantation in Severe Dry Eyes Secondary to Cicatrizing Conjunctivitis

Purpose To evaluate the long-term results of autologous submandibular gland transplantation in eyes with cicatrizing conjunctivitis and to determine biomechanical and biochemical features of the resulting salivary tear film. Design Prospective, observational case series. Methods Fifteen eyes with ci...

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Bibliographic Details
Published in:	American journal of ophthalmology Vol. 150; no. 6; pp. 894 - 904
Main Authors:	Borrelli, Maria, Schröder, Christina, Dart, John K.G, Collin, John Richard O, Sieg, Peter, Cree, Ian A, Matheson, Melville A, Tiffany, John M, Proctor, Gordon, van Best, Jaap, Hyde, Nick, Geerling, Gerd
Format:	Journal Article
Language:	English
Published:	New York, NY Elsevier Inc 01-12-2010 Elsevier Elsevier Limited
Subjects:	Adolescent Adult Aged Aged, 80 and over Biological and medical sciences Cell culture Cicatrix - pathology Cicatrix - surgery Conjunctivitis - complications Conjunctivitis - physiopathology Conjunctivitis - surgery Disease Dry Eye Syndromes - etiology Dry Eye Syndromes - physiopathology Dry Eye Syndromes - surgery Eyes & eyesight Family medical history Female Follow-Up Studies Graft Survival - physiology Hospitals Humans Male Medical sciences Middle Aged Miscellaneous Mucins - metabolism Ophthalmology Pharmaceuticals Postoperative Complications Prospective Studies Submandibular Gland - transplantation Surface Tension Surgery Tears - chemistry Tears - metabolism Transplantation, Autologous Transplants & implants Viscosity Visual Acuity - physiology Young Adult Secondary Scar Submandibular gland Transplantation Conjunctiva disease Conjunctivitis Long term Dry eye syndrome Eye disease Treatment Dry eye Surgery Graft Ophthalmology Severe
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Summary:	Purpose To evaluate the long-term results of autologous submandibular gland transplantation in eyes with cicatrizing conjunctivitis and to determine biomechanical and biochemical features of the resulting salivary tear film. Design Prospective, observational case series. Methods Fifteen eyes with cicatrizing conjunctivitis with a viable autologous submandibular gland transplantation were compared with 10 eyes with cicatrizing conjunctivitis and a failed submandibular gland transplantation or no submandibular gland transplantation. Best-corrected visual acuity, frequency of tear substitute instillation, severity of dry eye discomfort, lid margin erythema, conjunctival hyperemia, corneal epithelial edema, tear film break-up time, Schirmer test results, and corneal fluorescein and conjunctival Rose Bengal staining were evaluated. In a subgroup central corneal thickness and sensitivity, corneal epithelial barrier function, conjunctival and lid margin flora, and conjunctival impression cytologic analysis results were evaluated. In 3 patients, preoperative and postoperative tear samples were analyzed for viscosity, surface tension, and presence of mucins. Results Submandibular gland autotransplantation resulted in long-term improvement of subjective, objective, and some ocular surface parameters. Salivary mucins were detectable in salivary tears after submandibular gland transplantation. The viscosity of salivary tears was more similar to normal saliva and the surface tension was intermediate between the 2 original secretions. Conclusions Submandibular gland autotransplantation provides long-term relief from pain and reduces the need for frequent installation of lubricants.
Bibliography:	ObjectType-Article-1 SourceType-Scholarly Journals-1 ObjectType-Feature-2 content type line 23
ISSN:	0002-9394 1879-1891
DOI:	10.1016/j.ajo.2010.05.010