Surgical Treatment of Dry Eye Syndrome: Conjunctival Graft of the Minor Salivary Gland

Purpose: to develop a method of surgical treatment of patients with corneal ulcers of xerotic etiology and evaluate its efficacy in different time periods after operation. Materials and methods: 68 patients (86 eyes) with severe dry eye syndrome complicated by xerotic corneal ulcers were examined. In all patients, the ulcer defect was covered with conjunctiva and amniotic membrane. The operation was combined with an outer tarsorrhaphy and temporary blepharorraphy. Results: All 86 eyes (100%) achieved total closure of the ulcer defect, sealing of any perforation and maintaining of corneal transparency beyond the ulcer defect. Conclusion: Surgical closure of corneal ulcers with conjunctiva is an effective method of treatment of xerotic corneal ulcers. It could be recommended in patients with corneal perforation and tendency of descemetocele formation.

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Orbital implantation of submandibular salivary gland for dry eye syndrome

TNOA Journal of Ophthalmic Science and Research ◽

10.4103/tjosr.tjosr_22_17 ◽

2017 ◽

Vol 55 (3) ◽

pp. 243

Author(s):

G Baskararajan ◽

B Bhuvanasundari

Keyword(s):

Salivary Gland ◽

Dry Eye ◽

Dry Eye Syndrome ◽

Submandibular Salivary Gland

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Quality of life in patients submitted to surgical treatment for minor salivary gland neoplasms

Brazilian Oral Research ◽

10.1590/s1806-83242007000400016 ◽

2007 ◽

Vol 21 (4) ◽

pp. 375-379 ◽

Cited By ~ 2

Author(s):

Sílvio Kenji Hirota ◽

Sibele Sarti Penha ◽

Carlos Neutzling Lehn ◽

Norberto Nobuo Sugaya ◽

Dante Antônio Migliari

Keyword(s):

Quality Of Life ◽

Salivary Gland ◽

Surgical Treatment ◽

Family Relationships ◽

Minor Salivary Gland ◽

Well Being ◽

Salivary Gland Neoplasms ◽

Low Grade ◽

Emotional Status

This study was aimed at assessing the quality of life in patients submitted to surgical treatment for minor salivary gland neoplasms (MSGN). Twelve patients (10 women and 2 men, mean age: 49.4 years) with histopathologic diagnosis of pleomorphic adenoma (PA, 3 cases), polymorphous low-grade adenocarcinoma (PLGA, 2 cases), cystic adenoid carcinoma (CAC, 4 cases), and muco-epidermoid carcinoma (MEC, 3 cases) were evaluated. All of them were treated by surgical excision; patients with CAC received radiotherapy as well. The patients’ quality of life was evaluated through a self-administered questionnaire concerning their physical well-being, emotional status, normal daily activities, and family relationships. The results showed that patients with MEC - the youngest among all patients - reported a significantly greater worsening of their physical well-being and emotional status after treatment as compared with patients treated for PA (P < 0.05), and also of their functional activities as compared with those treated for PA and PLGA (P < 0.05). In conclusion, age of development of the neoplasm and type of disease produce more impact on patients’ quality of life than does the therapy’s degree of aggression.

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Clinical Correlations of Novel Autoantibodies in Patients with Dry Eye

Journal of Immunology Research ◽

10.1155/2019/7935451 ◽

2019 ◽

Vol 2019 ◽

pp. 1-8 ◽

Cited By ~ 3

Author(s):

Sezen Karakus ◽

Alan N. Baer ◽

Esen K. Akpek

Keyword(s):

Salivary Gland ◽

Dry Eye ◽

Minor Salivary Gland ◽

False Negative ◽

High Rate ◽

The Novel ◽

Serological Testing ◽

Minor Salivary Gland Biopsy ◽

Medical Diagnoses ◽

Salivary Gland Biopsy

Background. Diagnostic criteria for Sjögren’s syndrome (SS) are continually being updated in pursuit of more precise and earlier diagnosis to prevent its complications. Owing to the high rate of false negative traditional serological markers, the need for better serological testing remains. Objective. To investigate the clinical significance of three recently discovered novel autoantibodies, anti-salivary gland protein 1 (SP1), anti-carbonic anhydrase 6 (CA6), and anti-parotid secretory protein (PSP), in a cohort of dry eye patients with suspected underlying inflammatory/autoimmune disease. Methods. Medical records of 136 patients with a primary diagnosis of dry eye who underwent laboratory testing between April 2014 and July 2017 were reviewed retrospectively. Data regarding demographic information, ocular and systemic symptoms, previous medical diagnoses, serological test results, and minor salivary gland biopsy results were collected. Dry eye evaluations included tear osmolarity, Schirmer test without anesthesia, conjunctival lissamine green staining, and corneal fluorescein staining in the order listed here. Results. Of the 136 patients, 9 (9/136, 6.6%) presented with a history of SS, and 9 additional patients (9/127, 7%) received a new diagnosis of SS as a result of evaluations. Fifty-six patients (56/136, 41%) tested positive for at least one of the novel autoantibodies. Fifty-four percent (6/11) of patients with primary SS who underwent the novel serological testing had a positive anti-PSP. Of those, 2 (2/11, 18%) had negative traditional serology and had to undergo minor salivary gland biopsy for definitive diagnosis. Anti-CA6 was associated with increased corneal and conjunctival staining after adjusting for age, sex, and other serologic markers (HR=1.5, 95% CI=1.20-1.97, and p=0.009 and HR=1.4, 95% CI=1.04-1.76, and p=0.02, respectively). Conclusions. This cross-sectional study demonstrated that anti-CA6 is seen in patients with severe aqueous-deficient dry eye. Whether these patients have an early stage of SS or a different type of autoimmune condition may be determined through longitudinal studies.

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Minor salivary gland transplantation for severe dry eye disease due to cicatrising conjunctivitis: multicentre long-term outcomes of a modified technique

British Journal of Ophthalmology ◽

10.1136/bjophthalmol-2020-316611 ◽

2020 ◽

pp. bjophthalmol-2020-316611

Author(s):

Jayesh Vazirani ◽

Swapnil Bhalekar ◽

Guillermo Amescua ◽

Swati Singh ◽

Sayan Basu

Keyword(s):

Visual Acuity ◽

Salivary Gland ◽

Dry Eye ◽

Minor Salivary Gland ◽

Case Series ◽

Dry Eye Disease ◽

Secondary Outcome ◽

Eye Disease ◽

Modified Technique

AimTo report the clinical outcomes of autologous minor salivary gland transplantation (MSGT) for the treatment of severe dry eye disease caused by cicatrising conjunctivitis.MethodsThis was a retrospective case series of patients undergoing MSGT at four different centres from 2016 to 2018. The technical modifications included en bloc harvesting of a 20 mm×15 mm mucosa–gland–muscle complex and fixation of the glands to the superior bulbar surface anchored to the superior rectus muscle. The primary outcome measure was improvement in best-corrected visual acuity (BCVA). Secondary outcome measures were change in Schirmer test scores and grades of conjunctival and corneal fluorescein staining, grades of corneal neovascularisation, opacification and keratinisation.Results21 eyes of 19 patients underwent MSGT, with a median follow-up duration of 3 years. The median BCVA improved from a baseline value of 20/500 to 20/125 at 1 year (p=0.0004) and 20/80 at 3 years (p=0.0002) after surgery. The proportion of cases with BCVA ≥20/200 improved from 38% at baseline to 67% at 1 year (p=0.0294), 78% at 2 years (p=0.0227) and 93% at 3 years (p=0.0015) after surgery. There was a significant improvement (p<0.0036) in Schirmer scores, conjunctival and corneal staining scores as well as grades of corneal neovascularisation and opacification after surgery. There were no serious sight-threatening complications in the transplanted eyes or at the donor site.ConclusionsLong-term improvement in the visual acuity, ocular surface environment, and keratopathy was noted after MSGT performed in severely dry eyes using a modified technique.

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