Transplantation of salivary gland can treat severe dry eye.

[André Pereira]

Transplantation of salivary gland can treat severe dry eye, a surgeon says

The transplantation of accessory salivary glands can significantly reduce the signs and symptoms of dry eye, according to the study presented.

"The severe dry eye is primarily responsible for the destruction of the ocular surface, including cornea. Current treatments such as eyedrops or corneal-scleral patch did not produce optimal results, then look for new alternatives, "said Dr. Horacio Soriano, Argentina.

Dr. Soriano and colleagues evaluated the effects of the surgical procedure that involves the cultivation of accessory salivary glands from the patient's mouth and the transplantation of glands of the upper eyelid with conjunctival incision.

The researchers observed that 100% of patients had improvement in symptoms, including non-operated eye. Only 28% of patients reported needing lubricant eye drops when outdoors and all patients had a shorter tear film break, except in some cases such as Sjogren's syndrome.

"The patient has no other complaints, except for mucous secretion present in the first weeks after the third surgery," Dr. Soriano emphasized.

Has anyone heard of this?

[~Lin]

Its been used to treat dry eye in dogs for a while now but is a slightly different surgery. In dogs rather than transplanting the salivary gland they re-route it to the eye. This causes excessive watering of the eye during times when the dog's mouth would water such as feeding time. I've heard mixed things about it, sometimes it causes mineral deposits in the eye. Its called parotid duct transposition if you'd like to read more about pro's and cons. I realize you are not asking about it for a dog, but dry eye is treated identically in dogs and humans. Cyclosporine (restasis) was a long standing dry eye medication in dogs called optimmune before approved for humans.

[Ariel]

This was published a good while back. I'd think there would be more recent studies judging by the results.


To study the clinical effects of the secretion of transplanted labial glands used as ocular lubricant to treat severe dry-eye cases, to evaluate the duration of the results and to simplify the surgical technique.

METHODS: Thirty-seven surgeries were performed in twenty-one patients during the period of July 2000 to January 2004. The graft, consisting of labial mucosa and underlying salivary glands, was transplanted to the previously prepared area in the conjunctival fornix. All procedures were recommended in severe dry-eye cases, that is, eyes with total or nearly total xerophthalmia. The preoperative and postoperative protocols are presented emphasizing the items which were used in the comparative analysis of the results as well as the technical description of the surgical procedure.

RESULTS: The graft survival and integration into the host tissues were observed in 97.2% of the cases. The clinical improvement, demonstrated by the disappearance of the symptoms, better biomicroscopic aspect of the ocular surface, better vision and disuse of lubricant drops, was observed in 91.9% of the cases. The follow-up showed not only persistence but also stability of the results. Infection represented one case and ptosis represented three cases of the only four observed complications.

CONCLUSION: 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.

[wetEyes]

As far as I know, only a handful of teams worldwide are performing this surgery. I know a guy who had extreme dry eye due to Grafi-versus-host-disease who had this surgery in Germany and now has his life back.

[hirentherock]

i also know a person who has this surgery followed up with MOOKP.
the patient was totally blind to see before the surgery.was highly photophobic(just like me). he wudnt be able to go out in sun even with darkesh goggles.

The patient now can go out without spects, uses eye drops once a day.and his vision is more than a normal eye's vision.He can drive as well now.
The surgery was performed by a german doctor at LV PRASAD EYE INSTITUTE,hyderabad, INDIA

[Ariel]

Hirentherock-- Are you considering this surgery?

[hirentherock]

I will visit the patient who had this surgery done.
i have scheduled the meet with patient at doctors clinic which is far away from here.The patient is to come for a follow up check up on sept 18 2010.i will go there on the same date and see how does it look and feel to him.

He has done MOOKP...and i just googled it, and got many snaps of ppl who had it done.Eyes look awefully scary after surgery.So i wil be taking step back if that patient also looks same.But will consider salivary gland transplant.

[Ariel]

I'm also interested in looking into this. My doctor has told me it is an option to consider but I wouldn't want him to be the one operating on me. I think you're doing the right thing researching this as much as you can. Please keep us posted about your findings. I should tell you I only began considering this very recently after discarding other possibilities that weren't so extreme.

What is your diagnosis? What are you taking for pain management?

[hirentherock]

I have SJS for last 20 years im 28 now.Im 1 of most severe cases my doctor has seen.
My vision stat is disappointing. 1 eye having 6/60 and the other eye has finger counting vision.I have severe photophobia.the low vision eye has many more complications.

Im using genteal eye drops 4x.Using ointment once a week or so.I dont use ointment at night coz it gives stringing feeling the next day.

Whats ur findings regarding salivary gland transplant? whats ur complications?

[Ariel]

I don't have SJS. My DE condition is not as severe as yours so I don't think this procedure is something for me to rush into, at least for now.

[PaulineD]

Any thoughts about this?