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Federal University of Sao Paulo Vision Institute Sao Paulo. SP. Brazil.

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 .

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Federal University of Sao Paulo Vision Institute Sao Paulo. SP. Brazil.

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  1. Ana Estela BPP Sant´Anna, RossenHarzarbassanov, Aline L Araújo, Tammy H Osaki, Midori H Osaki, Vera LL Costa, Hellen PR Santos, Denise de Freitas, José AP Gomes Efficacy of Salivary Gland and Labial Mucous Membrane Transplantation in the treatment of severe symblepharon and dry eye secondary to Stevens-Johnson Syndrome We do nothaveany financial interestsorrelationships to disclose Federal University of Sao Paulo Vision Institute Sao Paulo. SP. Brazil.

  2. Stevens-JonhsonSyndrome Stevens-Jonhson syndrome is an immunological disease that causes dry eye and severe cicatricial changes in the cornea, conjunctiva and eyelids.

  3. Purpose • Evaluate salivary gland and labial mucous membrane transplantation in the treatment of patients with severe symblepharon and dry eye secondary to SSJ

  4. Patients and Methods • Design • Prospective interventional non-comparative case series • Federal University of Sao Paulo. Sao Paulo. SP. Brazil. • 2006 -2009 • Inclusion criteria • Stevens-Johnson syndrome • Severe dry eye • Previous Schirmer I test = 0 • Severe Symblepharon • Poor visual acuity

  5. Steps of surgery: • pre operative, • obtaining mucous membrane graft from inferior and superior lip with Ficasmucotome, • labial mucous membrane attached to the sclera, • obtaining the salivary glands, • fixing the salivary glands, • postoperative.

  6. Results: SalivaryGlandTransplantation

  7. SalivaryGlandTransplantationFederal UniversityofSao Paulo • Results • 19 eyes (19 patientswith SJS) • Age: 10-58 yo (mean 31 yo) • FU time: 3-35 months (mean 19) • 47% improvementof VA Sant´Anna & Gomes, 2009

  8. Schirmer I test 14/19 patients (73%) 10 (52%) ≥ 2mm. 10 glands (p=0.0129)=increase tears Schirmer I test versus transplanted salivary glands

  9. 52.6% improvement corneal transparency 73.6% improvement corneal neovascularization

  10. Post Pre Pre Post

  11. Pre Post Preandpostoperative. Noticethe labial mucosa harvestingtheentiresclera, atright. It lookslike a newconjunctiva

  12. Conclusions • Salivaryglandand oral mucosa tpseems to beefficient in treatingseveredryeye 2ry to SJS andmaybeimprovetheresultsoflimbal SC tp • Theprocedure is reproducibleandneeds to beperformedunder general anesthesia • More cases andlonger FU time are needed to furtherconfirmourfindings anestela@uol.com.br

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