Posters

Minor salivary gland transplantation in patients with severe dry eye secondary to Stevens–Johnson syndrome: a case series of ten cases from north–west India

Poster Details

First Author: S.Snehi INDIA

Co Author(s):    Z. Zadeng                    

Abstract Details

Purpose:

Steven-Johnson syndrome (SJS) is an inflammatory eye complication that may be caused by variety of drugs and infections. It may lead to severe dry eye that may eventually cause corneal opacity and vascularisation; cicatricial changes in ocular surface and eventually blindness. Minor salivary gland transplantation is a recently described surgical management option for patients with severe dry eye secondary to SJS. However, there is paucity of literature on this aspect especially from Indian subcontinent. We report our experience of minor salivary gland transplantation in patients with severe dry eye secondary to SJS.

Setting:

Advanced eye centre, Postgraduate Institute of Medical Education and Research, Chandigarh, India

Methods:

A prospective, non-comparative, interventional case series including patients with severe dry eye secondary to SJS. Minor salivary glands were harvested from buccal mucosa of lower lip and transplanted in superior conjunctival fornix. Pre-operatively, all patients were given chlorhexidine mouth wash and topical chloramphenicol. Postoperatively, all patients were given topical chloramphenicol (for 1 month) and topical corticosteroids (for 1 month). Patients were admitted for initial 4 days after surgery and were then regularly followed up in the clinic every week. Patient’s symptomatology, schirmer test, visual acuity, staining pattern of ocular surface and graft assessment was performed at each visit.

Results:

A total of 10 patients were included in the study. All patients had schirmer test score of 0 and impaired visual acuity (20/100 or worse) before transplantation. Significant improvement in eye symptoms (dryness, foreign body sensation); visual acuity and schirmer test result was noted in all patients after surgery. This improvement was maintained at a mean follow-up of 3 months in the entire cohort. No post-operative complications were noted in any patient.

Conclusions:

Minor salivary gland transplantation is an effective surgical option in patients with severe dry eye secondary to SJS. This may also increase the chance of successful limbal stem cell transplantation or corneal transplantation if needed in these patients.

Financial Disclosure:

None