Original articleLong-Term Follow-up after Submandibular Gland Transplantation in Severe Dry Eyes Secondary to Cicatrizing Conjunctivitis
Section snippets
Patient Groups
Between 1994 and the beginning of 2005, 44 eyes (35 patients) underwent an autologous submandibular gland transplantation. All patients had severe to absolute aqueous tear deficiency. Three months after surgery and during the subsequent follow-up, 35 of the 44 transplants were classified as viable. Viability was judged either on the basis of an increase of Schirmer test results or by means of technetium-99m–pertechnetate scintillography.17 Loss of graft viability was thought to be predominantly
Primary Surgical Success and Postoperative Complications
Early and late postoperative complications are listed in Table 2. One patient (2 eyes) died in the second postoperative year of cardiovascular disease.
Subjective Criteria
Before surgery, no difference between the transplantation group and the control group in visual acuity (P = .9), the frequency of tear substitute instillation (P = .4), and the severity of symptoms (P = .13) was found.
The best-corrected visual acuity in 7 of the 15 eyes in the transplantation group and in 4 of the 10 eyes in the control group was
Discussion
Herein we present the results of a prospective, controlled clinical cohort study on the long-term follow-up of submandibular gland autotransplantation in patients with cicatrizing conjunctivitis. Over a 5-year follow-up, submandibular gland transplantation provided lasting improvement of discomfort, of tear film parameters, and of some ocular surface parameters (fluorescein and Rose Bengal staining). However, other markers of ocular surface health, such as conjunctival hyperemia, metaplasia,
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