Abstract | OBJECTIVE: To evaluate minor salivary glands and labial mucous membrane graft in patients with severe symblepharon and dry eye secondary to Stevens-Johnson syndrome (SJS). METHODS: A prospective, non-comparative, interventional case series of 19 patients with severe symblepharon and dry eye secondary to SJS who underwent labial mucous membrane and minor salivary glands transplantation. A complete ophthalmic examination including the Schirmer I test was performed prior to and following surgery. All patients had a preoperative Schirmer I test value of zero. RESULTS: Nineteen patients with severe symblepharon and dry eye secondary to SJS were included in the study. There was a statistically significant improvement in the best spectacle-corrected visual acuity in eight patients (t test; p=0.0070). Values obtained in the Schirmer I test improved significantly in 14 eyes (73.7%) 6 months following surgery (χ(2) test; p=0.0094). A statistically significant increase in tear production (Schirmer I test) was found in eyes that received more than 10 glands per graft compared with eyes that received fewer glands (χ(2) test; p=0.0096). Corneal transparency improved significantly in 11 (72.2%) eyes and corneal neovascularisation improved significantly in five eyes (29.4%) (McNemar test; p=0.001 and p=0.0005). The symptoms questionnaire revealed improvement in foreign body sensation in 53.6% of the patients, in photophobia in 50.2% and in pain in 54.8% (Kruskal-Wallis test; p=0.0167). CONCLUSION: Labial mucous membrane and minor salivary glands transplantation were found to constitute a good option for the treatment of severe symblepharon and dry eye secondary to SJS. This may be considered as a step prior to limbal stem cell and corneal transplantation in these patients.
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Authors | Ana Estela B P P Sant' Anna, Rossen M Hazarbassanov, Denise de Freitas, José Álvaro P Gomes |
Journal | The British journal of ophthalmology
(Br J Ophthalmol)
Vol. 96
Issue 2
Pg. 234-9
(Feb 2012)
ISSN: 1468-2079 [Electronic] England |
PMID | 21527414
(Publication Type: Journal Article)
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Topics |
- Adult
- Conjunctival Diseases
(etiology, physiopathology, surgery)
- Cornea
(physiopathology)
- Dry Eye Syndromes
(etiology, physiopathology, surgery)
- Eyelid Diseases
(etiology, physiopathology, surgery)
- Female
- Humans
- Labial Frenum
- Male
- Mouth Mucosa
(transplantation)
- Prospective Studies
- Salivary Glands, Minor
(transplantation)
- Stevens-Johnson Syndrome
(complications)
- Surveys and Questionnaires
- Suture Techniques
- Tears
(physiology)
- Treatment Outcome
- Visual Acuity
(physiology)
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