Minor salivary glands and labial mucous membrane graft in the treatment of severe symblepharon and dry eye in patients with Stevens-Johnson syndrome
Minor salivary glands and labial mucous membrane graft in the treatment of severe symblepharon and dry eye in patients with Stevens-Johnson syndrome
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DOI：
10.1136/bjo.2010.199901
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发表时间：
2012-02-01
影响因子：
4.1
通讯作者：
Gomes, Jose Alvaro P.
中科院分区：
文献类型：
--
作者：
Anna, Ana Estela B. P. P. Sant';Hazarbassanov, Rossen M.;Gomes, Jose Alvaro P.
目的探讨小唾液腺和唇粘膜移植治疗重症重症睑球粘连和干眼症的疗效。术前和术后进行了完整的眼科检查，包括Schirmer I试验。所有患者术前Schirmer I测试值为zero.Results 19例严重睑球粘连和干眼症继发于SJS的患者被纳入本研究。8例患者的最佳矫正视力有统计学显著改善（t检验; p = 0.0070）。术后6个月，14只眼（73.7%）的Schirmer I检验值显著改善（卡方检验; p = 0.0094）。与接受较少腺体的眼睛相比，接受超过10个腺体/移植物的眼睛的泪液分泌量在统计学上显著增加（Schirmer I检验）（卡方检验; p = 0.0096）。11只眼（72.2%）的角膜透明度显著改善，5只眼（29.4%）的角膜新生血管显著改善（McNemar检验; p = 0.001和p = 0.0005）。症状问卷显示，53.6%的患者异物感改善，50.2%的患者畏光改善，54.8%的患者疼痛改善（Kruskal-Wallis检验; p = 0.0167）。结论唇粘膜和小唾液腺移植是治疗SJS引起的严重睑球粘连和干眼症的良好选择。这可能被认为是在这些患者中进行角膜缘干细胞和角膜移植之前的一个步骤。
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 (chi(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 (chi(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.