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Juan Murube, MD, PhD (Spain)

Juan Murube, MD, PhD (Spain). THE TWO EASIEST SURGERIES TO TREAT DRY EYE: 1. PUNCTUM PATCHING 2. CISTERNOPLASTY _____________________________. WHY SPEAK ABOUT THE SURGICAL TREATMENT OF DRY EYE?. DRY EYE IS THE MOST FREQUENT DISEASE IN OPHTHALMOLOGY.

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Juan Murube, MD, PhD (Spain)

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  1. Juan Murube, MD, PhD (Spain) THE TWO EASIEST SURGERIES TO TREAT DRY EYE: 1. PUNCTUM PATCHING 2. CISTERNOPLASTY _____________________________

  2. WHY SPEAK ABOUT THE SURGICAL TREATMENT OF DRY EYE? • DRY EYE IS THE MOST FREQUENT DISEASE IN OPHTHALMOLOGY. • DRY EYE AND GLAUCOMA ARE AT PRESENT THE MOST FREQUENT CHRONIC MEDICAL TREATMENTS IN OPHTHALMOLOGY. • ALL PEOPLE WILL SUFFER DRY EYE IF THEY LIVE LONG ENOUGH. • AT PRESENT DRY EYE HAS NO CURE, AND TREATMENT IS ONLY PALLIATIVE • IN THE NEAR FUTURE, SURGICAL TREATMENT OF DRY EYE WILL GREATLY INCREASE IN FREQUENCY.

  3. THE TRIPLE CLASSIFICATION OF DRY EYE I. ETIOPATHOGENIC II. HISTOGLANDULAR III. SEVERITY 1. Age-related A queo-deficient 1. Mild. 2. Hormonal L ipo-deficient 2. Moderate 3. Pharmacologic M ucin-deficient 3. Severe 4. Immunopathic E pitheliopathic 5. Hyponutritional N on ocular dryness 6. Dysgenetic 7. Adenitic 8. Traumatic 9. Neurodeprivative 10. Tantalic

  4. SURGICAL TREATMENT 1. SUPPLYING FLUID TO THE LACRIMAL POOL PAROTID DUCT TRANSPOSITION SALIVARY GLAND TRANSPLANTATION ABDOMINAL RESERVOIR 2. RETAINING FLUID IN THE LACRIMAL POOL PUNCTUM OCCLUSION CISTERNOPLASTY

  5. STENO’s DUCT TRANSPOSITION, 1951

  6. TRANSPLANTATION OF MAJOR SALIVARY GLANDS to the TEMPORAL FOSSA, 1986

  7. TRANSPLANTATION OF MINOR GLANDS (f.i. labial) TO THE SURFOCULUS

  8. SUBCUTANEOUS ABDOMINAL RESERVOIRS

  9. SURGICAL TREATMENT 1. SUPPLYING FLUID TO THE SURFOCULAR POOL PAROTID DUCT TRANSPOSITION SALIVARY GLAND TRANSPLANTATATION ABDOMINAL RESERVOIR 2. RETAINING FLUID IN THE SURFOCULAR POOL PUNCTUM OCCLUSION CISTERNOPLASTY

  10. 3 METHODS FOR THERMAL OCCLUSION:1. GALVANOCAUTEY2. DIATHERMY3. LASER

  11. PUNCTUM PLUGSiniciated by Freeman in 1975

  12. PUNCTUM OCCLUSION WITH SMART PLUGS

  13. PATCHING OF THE LACRIMAL PUNCTUM with autologous conjunctiva

  14. PUNCTUM PATCHING with AUTOLOGOUS SKIN

  15. 2, CISTERNOPLASTY -THE VOLUME OF A NORMAL LACRIMAL BASIN IS ≈ 7 μl. • A DROP OF ARTIFICIAL TEAR HAS ≈ 30 μl, AND OVERCHARGES THE LACRIMAL POOL. • FIVE MINUTES AFTER INSTILLING THE DROP, THE LACRIMAL POOL RETURNS TO ≈ 7 μl. • IT WAS MANDATORY TO LOOK FOR A SOLUTION TO THIS WASTE !

  16. CISTERNOPLASTY A CISTERNOPLASTY QUADRUPLICATES THE CONTENT OF THE LACRIMAL BASIN, AND THE TIME OF RETENTION

  17. THANKS FOR YOUR ATTENTION • PUNCTUM PATCHING WITH 1. AUTOLOGOUS CONJUNCTIVA OR LID SKIN…… 2. AND CISTERNOPLASTY DO NOT CURE, …BUT GREATLY IMPROVE THE LIFE OF PEOPLE DEFINED IN THE TRIPLE CLASSIFICATION OF DRY EYE AS HAVING MEDIUM AND SEVERE DRY EYE

  18. GARRET

  19. ABDOMINAL RESERVOIR IS THE ONLY TECHNIQUE THAT ALLOWS TO PERFORM A SUCCESSFUL KERATOPLASTY IN TOTAL DRY EYES

  20. PUNTUM PLUGSiniciated by Freeman in 1975

  21. PUNCTUM PLUG

  22. CAUTERIZATION OF THE LACRIMAL CANALICULI

  23. TREATMENT OF DRY EYE 1. PSYCHOLOGIC 2. ENVIRONMENTAL 3. MEDICAL 4. SURGICAL

  24. PUNCTUM PATCHING with AUTOLOGOUS SKIN

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