Long-Term Follow-up after Submandibular Gland Transplantation in Severe Dry Eyes Secondary to Cicatrizing Conjunctivitis
Long-Term Follow-up after Submandibular Gland Transplantation in Severe Dry Eyes Secondary to Cicatrizing Conjunctivitis
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DOI：
10.1016/j.ajo.2010.05.010
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发表时间：
2010-12-01
影响因子：
4.2
通讯作者：
Geerling, Gerd
中科院分区：
文献类型：
--
作者：
Borrelli, Maria;Schroeder, Christina;Geerling, Gerd
目的：评估自体颌下腺移植对患有疤痕性结膜炎的眼睛的长期结果，并确定由此产生的唾液泪膜的生物力学和生化特征。设计：前瞻性、观察性病例系列。方法：将可行的自体颌下腺移植的 15 只患有疤痕性结膜炎的眼睛与患有疤痕性结膜炎且失败的 10 只眼睛进行比较颌下腺移植或不进行颌下腺移植。评估最佳矫正视力、泪液替代品滴注频率、干眼不适的严重程度、眼睑边缘红斑、结膜充血、角膜上皮水肿、泪膜破裂时间、Schirmer试验结果以及角膜荧光素和结膜玫瑰红染色。在亚组中，评估了中央角膜厚度和敏感性、角膜上皮屏障功能、结膜和眼睑边缘菌群以及结膜印迹细胞学分析结果。对 3 名患者的术前和术后泪液样本进行了粘度、表面张力和粘蛋白的分析。结果：自体下颌下腺移植使主观、客观和一些眼表参数得到长期改善。颌下腺移植后，在唾液泪液中可检测到唾液粘蛋白。唾液泪液的粘度与正常唾液更相似，表面张力介于两种原始分泌物之间。结论：颌下腺自体移植可以长期缓解疼痛，并减少频繁安装润滑剂的需要。 （美国眼科杂志 2010 年；150：894-904。(C) 2010 年，Elsevier Inc. 保留所有权利。）
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. (Am J Ophthalmol 2010;150:894-904. (C) 2010 by Elsevier Inc. All rights reserved.)