in cases of severe dry eyes labial salivary glands can be transplanted to the eyelid to lubricate the eye. New dry eye treatment

Dry eyes are a common problem that can be caused by multiple factors. In a majority of cases treatment is limited to a substitution for the lack of normal tears. A prevention of the outflow of tears to the nose by putting a silicone plug in the tear duct is another possible treatment.

Indeed, a lot of artificial tears, gels and ointments are available for the patients with dry eyes and the ophthalmologist can put plugs in the tear duct or surgically close these ducts.

Actually a whole new treatment is available for patients with severe dry eyes when even frequent instillations of lubricants are not enough to comfort the patient and even closing the tear ducts appears not to be sufficient.

It is the transplantation of mucosa and salivary glands from the lower lip to the inner, so called conjunctival side of the eyelids.

It was Prof. Juan Murube from Madrid who discovered that the saliva that is secreted by these specific glands is very similar to natural tears and that the glands continue to function when carefully dissected and transplanted to the eyelids.

The glands are easily accessible in the lower lip.

With Radiosurgery, using high frequency radio waves, the glands and overlying mucosa are carefully dissected and transplanted to the inner side of both upper and lower eyelid.

The transplant is sutured with a running Prolene suture that can already be taken out after 2 weeks.

At that time in most cases patients can already feel the beneficial effects of the secretion of the salivary glands so that the can diminish the frequency of instillations of artificial tears.

The operation is done under general anesthesia and because the treated eye is patched during the first week after surgery, I prefer to treat both eyes separately with an interval of at least one month.

Up to now, I treated 17 eyes with this technique. All patients improved significantly after surgery although some of them still have to put artificial tears, be it at a much lower frequency.

Transplantation of labial salivary glands to the conjunctiva thus promises to be a reliable new treatment in cases of severe dry eyes that are resistant to other therapies.

Peter Raus MD

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