Transplante de glândulas salivares labiais no tratamento do olho seco grave

Abstract

The improvement of severe dry-eye cases detected after the transplantation of labial salivary glands is significant. It demonstrates that the lubricant ocular surface produced by the salivary secretion is efficient and well-tolerated. The follow-up shows that the result persists in the long term from which it is concluded that the production of the secretion is permanent. The surgical technique of transplanting the labial salivary gland to the conjunctival fornix is very simple and easily accessible to any ophthalmic surgeon.

Transplante de glândulas salivares labiais no tratamento de olho seco em cães pela autoenxertia

“…Transplantation of labial salivary glands into the conjunctival fornix to treat severe dry eye syndrome has shown satisfactory results in experiments with humans, with statistically significant clinical improvement (5) . Although there are several alternatives for the treatment of dry eye syndrome, some cases represent a therapeutic challenge, particularly those with immunemediated causes, prompting the need for new treatment alternatives.…”

“…Lubrication of the ocular surface by salivary secretion was shown to be effective, well tolerated, and constant in humans (5) . This prompted the present study in dogs, a species where dry eye syndrome can have autoimmune causes making it a good model for comparative ophthalmology.…”

“…The clinical improvement observed after grafting associated with lubricating eye drops is due to the fact that lacrimal gland secretion contains elements which maintain and protect the ocular surface, especially a higher concentration of mucin, which increases the viscosity of the "salivary tears". The more viscous secretion decreases evaporation, forming a more permanent and stable wet layer (5) . In our study, we found a significant reduction of mucopurulent discharge and increased BUT, promoting stability of the tear film and reducing evaporation.…”

“…The labial salivary gland grafts were pale only in the first hours after the procedure, but with no signs of distress; it is essential that the grafts be incorporated into the recipient site and regain their original pink colour by the second PO day (5) . The grafts were integrated into the recipient site within 48 hours, as shown by the rapid recovery of normal colour and the better lubrication and improved luster of the ocular surface, with relief of symptoms and improved vision.…”

“…Transplantation of labial salivary glands into the conjunctival fornix to treat severe dry eye syndrome has shown satisfactory results in experiments in humans, with statisticallysignificant clinical improvement (5) . Thus, we used this new treatment alternative in dogs with KCS, assessing its effects and efficacy based on the clinical signs of KCS: ocular discharge, conjunctival hyperaemia, blepharospasm, corneal luster, corneal neovascularisation, quantification of tear production (Schirmer test), and tear film break-up time (BUT).…”