A Surgical Approach to Total Xerophthalmia

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Abstract
Introduction The treatment of total xerophthalmia has always been a very difficult problem. Total xerophthalmia frequently occurs following exfoliative dermatitis, ocular pemphigus, and trachoma, which are associated with complete loss of function of the lacrimal gland and all accessory lacrimal tissue. Conservative treatment, such as topical instillation of artificial tears, blocking of the puncta, tarsorraphy, transplantation of buccal mucosa, and vitamin A therapy is usually unsatisfactory and generally gives only temporary improvement. The usual course of total xerophthalmia is corneal ulceration, epidermidalization, and keratinization of corneal epithelium; symblepharon, and corneal vascularization with progressive visual loss. Transplantation of the parotid duct into the lower conjunctival cul-de-sac offers a new approach towards the solution of this problem. Comment In 1950, Filatov1 and his associates first reported the successful transplantation of the parotid duct into the conjunctival sac for the treatment of total xerophthalmia, and subsequently they have reported 80 cases. Additional

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