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ARTICLE
Year : 1964  |  Volume : 12  |  Issue : 2  |  Page : 74

A note on the results of parotid duct transplantation in total xerophthalmia


Department of Ophthalmology, K.E.M. Hospital, Bombay 12, India

Date of Web Publication14-Feb-2008

Correspondence Address:
B T Maskati
Department of Ophthalmology, K.E.M. Hospital, Bombay 12
India
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Source of Support: None, Conflict of Interest: None


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How to cite this article:
Maskati B T, Mody D G, Ursekar T N. A note on the results of parotid duct transplantation in total xerophthalmia. Indian J Ophthalmol 1964;12:74

How to cite this URL:
Maskati B T, Mody D G, Ursekar T N. A note on the results of parotid duct transplantation in total xerophthalmia. Indian J Ophthalmol [serial online] 1964 [cited 2020 Dec 3];12:74. Available from: https://www.ijo.in/text.asp?1964/12/2/74/39079

In India, due to a very high inci­dence and severity of trachoma, tra­chomatous xerophthalmia stands out as a cause of blindness which poses a formidable challenge to ophthalmolog­ists.

The new surgical approach of trans­plantation of the Parotid Duct into the lower fornix of the conjunctiva has brought a measure of some relief in this incurable condition.

Conservative treatment, like local instillation of Methyl Cellulose, block­ing of the puncta, vitamin A therapy etc. only provides temporary relief and slowly but surely the corneal vas­cularisation, symblepheron and kera­tinisation of the conjunctival and cor­neal epithelium progresses, leading ultimately to marked visual loss. In 1950, Filatov and his associates first reported the successful transplantation of the parotid duct into the conjunctival sac for the treatment of total xeroph­thalmia, and subsequently Chinese and other workers have reported many successful cases.

After gaining some experience, by carrying out dissections on human cadaver, we successfully operated our first case in 1959. Since then we have operated on seven eyes in four pa­tients. Five of these eyes had total xerophthalmia due to trachoma, while in two eyes of the first patient the cause was caustic burns. Out of seven eyes operated, one developed parotid fistula, which healed by conservative treatment: two cases had infection of the skin wound on the cheek which healed leaving a sear. In one case the parotid duct was found to be short. This difficulty was overcome by pass­ing the duct underneath the masseter muscle. This however resulted in en­tropion of the lower lid due to pulling of the duct. The entropion was later corrected. The conjunctival sac was found moist by the parotid secretion on about the fourth day after the operation. The parotid secretion which is profuse specially during meals for some time after the operation be­comes less and tolerable after about four to six months after the operation. There was definite subjective and ob­jective improvement in vision in all eyes operated. In none of the cases any new focus of xerosis was observed following the transplantation of the duct, probably due to the permanent wetting of the eye.




 

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