Insular infraorbital neurovascular pedicle labial salivary gland transplantation for the treatment of severe dry eye disease: an IDEAL stage 0, 1 and 2a study
Objectives To address the lack of nerve and blood supply after labial salivary gland transplantation (LSGT) resulting in glandular atrophy. We designed a modified LSGT, called insular infraorbital neurovascular pedicle LSGT, and evaluated the postoperative efficacy.Design This is a prospective, sing...
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BMJ Publishing Group
2025-01-01
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| Series: | BMJ Surgery, Interventions, & Health Technologies |
| Online Access: | https://sit.bmj.com/content/7/1/e000324.full |
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| author | Jing Zhou Xiaohong Chen Mei Li Ke Yang Ying Jie Yinghui Wang Yingshi Piao Yun Cheng |
| author_facet | Jing Zhou Xiaohong Chen Mei Li Ke Yang Ying Jie Yinghui Wang Yingshi Piao Yun Cheng |
| author_sort | Jing Zhou |
| collection | DOAJ |
| description | Objectives To address the lack of nerve and blood supply after labial salivary gland transplantation (LSGT) resulting in glandular atrophy. We designed a modified LSGT, called insular infraorbital neurovascular pedicle LSGT, and evaluated the postoperative efficacy.Design This is a prospective, single-centre, self-contained study.Setting The research was conducted at Beijing Tongren Hospital, Capital Medical University from July 2019 to March 2024.Participants Eight patients (nine eyes) with severe dry eye disease (DED) were enrolled in this study.Interventions All patients underwent insular infraorbital neurovascular pedicle LSGT and were followed up for at least 6 months postoperatively.Main outcome measure Key evaluation indices were best-corrected visual acuity (BCVA), Ocular Surface Disease Index (OSDI) score, tear break-up time (TBUT), Corneal Fluorescence Staining (CFS) score, and Schirmer I test (SIT).Results With a mean follow-up of 17.56±11.72 months, BCVA improved in four eyes and stabilized in five. OSDI score decreased from 59.33±14.37 to 26.27±10.14 (p<0.001). SIT improved from 0.00±0.00 mm to 5.44±2.01 mm (p<0.0001). TBUT increased from 0.23±0.48 s to 5.48±4.67 s (p=0.008). CFS scores decreased from 12.56±2.65 to 7.56±3.09 (p<0.001). All glands remained viable with good blood supply, and no serious complications were observed.Conclusion Insular infraorbital neurovascular pedicle LSGT for severe DED is a feasible and effective treatment, maintaining good secretory capacity and blood supply long-term.Trial registration number ChiCTR2200056015. |
| format | Article |
| id | doaj-art-bdb3ef6d779c4b1a8610b186da517065 |
| institution | Kabale University |
| issn | 2631-4940 |
| language | English |
| publishDate | 2025-01-01 |
| publisher | BMJ Publishing Group |
| record_format | Article |
| series | BMJ Surgery, Interventions, & Health Technologies |
| spelling | doaj-art-bdb3ef6d779c4b1a8610b186da5170652025-01-07T18:20:08ZengBMJ Publishing GroupBMJ Surgery, Interventions, & Health Technologies2631-49402025-01-017110.1136/bmjsit-2024-000324Insular infraorbital neurovascular pedicle labial salivary gland transplantation for the treatment of severe dry eye disease: an IDEAL stage 0, 1 and 2a studyJing Zhou0Xiaohong Chen1Mei Li2Ke Yang3Ying Jie4Yinghui Wang5Yingshi Piao6Yun Cheng7Department of Cardiology, Peking University First Hospital, Beijing, ChinaDepartment of Otolaryngology-Head and Neck Surgery, Beijing Tongren Hospital, Capital Medical University, Beijing, People`s Republic of China2 Dermatology Medical Cosmetology Center, Ningbo Hospital of Traditional Chinese Medicine, Affiliated Hospital of Zhejiang Chinese Medical University, Ningbo, Zhejiang, China2 State Key Laboratory of Ophthalmology, Sun Yat-Sen University Zhongshan Ophthalmic Center, Guangzhou, China4Department of Ophthalmology, Beijing Tongren Eye Center, Beijing Tongren Hospital, Capital Medical University, Beijing, ChinaBeijing Institute of Ophthalmology, Beijing Tongren Eye Center, Beijing Tongren Hospital, Capital Medical University; Beijing Ophthalmology & Visual Sciences Key Laboratory, Beijing, People`s Republic of ChinaDepartment of Pathology, Capital Medical University, Beijing, ChinaDepartment of Ultrasound Diagnosis, Capital Medical University, Beijing, ChinaObjectives To address the lack of nerve and blood supply after labial salivary gland transplantation (LSGT) resulting in glandular atrophy. We designed a modified LSGT, called insular infraorbital neurovascular pedicle LSGT, and evaluated the postoperative efficacy.Design This is a prospective, single-centre, self-contained study.Setting The research was conducted at Beijing Tongren Hospital, Capital Medical University from July 2019 to March 2024.Participants Eight patients (nine eyes) with severe dry eye disease (DED) were enrolled in this study.Interventions All patients underwent insular infraorbital neurovascular pedicle LSGT and were followed up for at least 6 months postoperatively.Main outcome measure Key evaluation indices were best-corrected visual acuity (BCVA), Ocular Surface Disease Index (OSDI) score, tear break-up time (TBUT), Corneal Fluorescence Staining (CFS) score, and Schirmer I test (SIT).Results With a mean follow-up of 17.56±11.72 months, BCVA improved in four eyes and stabilized in five. OSDI score decreased from 59.33±14.37 to 26.27±10.14 (p<0.001). SIT improved from 0.00±0.00 mm to 5.44±2.01 mm (p<0.0001). TBUT increased from 0.23±0.48 s to 5.48±4.67 s (p=0.008). CFS scores decreased from 12.56±2.65 to 7.56±3.09 (p<0.001). All glands remained viable with good blood supply, and no serious complications were observed.Conclusion Insular infraorbital neurovascular pedicle LSGT for severe DED is a feasible and effective treatment, maintaining good secretory capacity and blood supply long-term.Trial registration number ChiCTR2200056015.https://sit.bmj.com/content/7/1/e000324.full |
| spellingShingle | Jing Zhou Xiaohong Chen Mei Li Ke Yang Ying Jie Yinghui Wang Yingshi Piao Yun Cheng Insular infraorbital neurovascular pedicle labial salivary gland transplantation for the treatment of severe dry eye disease: an IDEAL stage 0, 1 and 2a study BMJ Surgery, Interventions, & Health Technologies |
| title | Insular infraorbital neurovascular pedicle labial salivary gland transplantation for the treatment of severe dry eye disease: an IDEAL stage 0, 1 and 2a study |
| title_full | Insular infraorbital neurovascular pedicle labial salivary gland transplantation for the treatment of severe dry eye disease: an IDEAL stage 0, 1 and 2a study |
| title_fullStr | Insular infraorbital neurovascular pedicle labial salivary gland transplantation for the treatment of severe dry eye disease: an IDEAL stage 0, 1 and 2a study |
| title_full_unstemmed | Insular infraorbital neurovascular pedicle labial salivary gland transplantation for the treatment of severe dry eye disease: an IDEAL stage 0, 1 and 2a study |
| title_short | Insular infraorbital neurovascular pedicle labial salivary gland transplantation for the treatment of severe dry eye disease: an IDEAL stage 0, 1 and 2a study |
| title_sort | insular infraorbital neurovascular pedicle labial salivary gland transplantation for the treatment of severe dry eye disease an ideal stage 0 1 and 2a study |
| url | https://sit.bmj.com/content/7/1/e000324.full |
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