A few years ago Prof. Juan Murube from the famous Alcalá University of Madrid in Spain discovered that the secretion product of the salivary glands from de lower lip is very similar to natural tears. He developed a surgical technique to transplant the glands to the inner side of the eyelids. These glands are easily accessible and can be transplanted to the eyelids together with the overlying mucosa. I slightly modified his technique by using radiosurgery and the use of a running suture instead of separate sutures With the patient under general anaesthesia a specimen of labial mucosa of the lower lip and underlying glands is dissected with Radiosurgery and transplanted to the inner, conjunctival side of the eyelid. The patients only have to stay in the hospital for one night and the running sutures can be taken out after already two weeks.
Results: At the time the sutures are removed,most patients already notice an improvement so that they can lower the frequency of instillations of artificial tears. To prove this subjective feeling of the patients after this new surgical technique I asked a pathologist to microscopically examine the transplanted tissue. Biopts of this transplanted tissue, taken after 18 and 36 months confirm the survival of the transplanted glands that maintain their basal secretion.
Conclusions: Up to February 2009 I treated 23 eyes with this technique and although more study has to be done on this type of surgery, the Radiosurgically assisted transplantation of labial salivary glands promises to be an excellent alternative for cases of very dry eyes when conventional treatments fail. Patients’ recovery is very fast with only minimal discomfort in the recovery time. However I would like to stress that this treatment is not the first choice therapy for all cases of dry eyes but has to be considered as a possible solution for severe cases.
The technique will be presented at the next European Congress of Ophthalmology (SOE) to be held in Amsterdam, June 13-16.
Recently a study was started at the University for Technology of Delft (TUDelft) to compare the tears of dry eye patients before and after transplantation. And in September we wery happy to find out, with the help of the University of Hasselt (LUC) that the labial salivary glands of the lip that I use for transplantation do indeed secrete the protein “lacritin” (immunohistochemistry)
This might be very important since Prof. Gordon Laurie is convinced that Lacritin plays a capital role in the process of dry eyes!
Interested patients can visit py website.
International patients can stay in the Corbie Hotel at walking distance from the Miró center.
Dr. Peter Raus