Presentation on theme: "Ana Estela BPP Sant´Anna, Rossen Harzarbassanov, Aline L Araújo, Tammy H Osaki, Midori H Osaki, Vera LL Costa, Hellen PR Santos, Denise de Freitas, José."— Presentation transcript:
Ana Estela BPP Sant´Anna, Rossen Harzarbassanov, Aline L Araújo, Tammy H Osaki, Midori H Osaki, Vera LL Costa, Hellen PR Santos, Denise de Freitas, José AP Gomes Federal University of Sao Paulo Vision Institute Sao Paulo. SP. Brazil. We do not have any financial interests or relationships to disclose
Stevens-Jonhson Syndrome Stevens-Jonhson syndrome is an immunological disease that causes dry eye and severe cicatricial changes in the cornea, conjunctiva and eyelids.
Purpose Evaluate salivary gland and labial mucous membrane transplantation in the treatment of patients with severe symblepharon and dry eye secondary to SSJ
Patients and Methods Design Prospective interventional non-comparative case series Federal University of Sao Paulo. Sao Paulo. SP. Brazil Inclusion criteria Stevens-Johnson syndrome ○ Severe dry eye Previous Schirmer I test = 0 ○ Severe Symblepharon ○ Poor visual acuity
Steps of surgery: A.pre operative, B.obtaining mucous membrane graft from inferior and superior lip with Ficas mucotome, C.labial mucous membrane attached to the sclera, D.obtaining the salivary glands, E.fixing the salivary glands, F.postoperative.
Results Results 19 eyes (19 patients with SJS) 19 eyes (19 patients with SJS) Age: yo (mean 31 yo) FU time: 3-35 months (mean 19) 47% improvement of VA 47% improvement of VA Salivary Gland Transplantation Federal University of Sao Paulo Sant´Anna & Gomes, 2009
Schirmer I test 14/19 patients (73%) 10 (52%) ≥ 2mm. 10 glands (p=0.0129) = increase tears Group1 (Schirmer =0mm) Group2 (Schirmer ≤2mm) Group3 (Schirmer <2mm) ϰ 2 test P= glands (0-5) 66.67(2/3)33.33(1/3)0(0/3) glands (5-10) 28.57(2/7) 42.86(3/7) glands ( > 10) 10(1/10)20(2/10)70(7/10) Schirmer I test versus transplanted salivary glands
Pre and postoperative. Notice the labial mucosa harvesting the entire sclera, at right. It looks like a new conjunctiva Pre Post
Conclusions Salivary gland and oral mucosa tp seems to be efficient in treating severe dry eye 2ry to SJS and maybe improve the results of limbal SC tp The procedure is reproducible and needs to be performed under general anesthesia More cases and longer FU time are needed to further confirm our findings