Conjunctivitis surgery: Difference between revisions
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==Overview== | ==Overview== | ||
Despite the availability of efficient tear substitutes, many patients with [[keratoconjunctivitis sicca|keratoconjunctivitis sicca (dry eye syndrome)]] experience severe [[corneal]] injuries and a subsequent loss of vision. Surgical techniques include [[lateral]] [[tarsorrhaphy]], punctal plugs, lens therapy, amniotic membrane transplantation, and [[salivary gland]] duct [[transposition]].<ref name="pmid26435586">{{cite journal| author=Rajak S, Rajak J, Selva D| title=Performing a tarsorrhaphy. | journal=Community Eye Health | year= 2015 | volume= 28 | issue= 89 | pages= 10-1 | pmid=26435586 | doi= | pmc=4579993 | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=26435586 }} </ref><ref name="pmid17216100">{{cite journal| author=Baxter SA, Laibson PR| title=Punctal plugs in the management of dry eyes. | journal=Ocul Surf | year= 2004 | volume= 2 | issue= 4 | pages= 255-65 | pmid=17216100 | doi= | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=17216100 }} </ref><ref name="pmid12912699">{{cite journal| author=Khodadoust A, Quinter AP| title=Microsurgical approach to the conjunctival flap. | journal=Arch Ophthalmol | year= 2003 | volume= 121 | issue= 8 | pages= 1189-93 | pmid=12912699 | doi=10.1001/archopht.121.8.1189 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=12912699 }} </ref><ref name="pmid14704553">{{cite journal| author=Güerrissi JO, Belmonte J| title=Surgical treatment of dry eye syndrome: conjunctival graft of the minor salivary gland. | journal=J Craniofac Surg | year= 2004 | volume= 15 | issue= 1 | pages= 6-10 | pmid=14704553 | doi= | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=14704553 }} </ref> | Despite the availability of efficient tear substitutes, many patients with [[keratoconjunctivitis sicca|keratoconjunctivitis sicca (dry eye syndrome)]] experience severe [[corneal]] injuries and a subsequent loss of vision. Surgical techniques include [[lateral]] [[tarsorrhaphy]], punctal plugs, lens therapy, amniotic membrane transplantation, and [[salivary gland]] duct [[transposition]].<ref name="pmid26435586">{{cite journal| author=Rajak S, Rajak J, Selva D| title=Performing a tarsorrhaphy. | journal=Community Eye Health | year= 2015 | volume= 28 | issue= 89 | pages= 10-1 | pmid=26435586 | doi= | pmc=4579993 | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=26435586 }} </ref><ref name="pmid17216100">{{cite journal| author=Baxter SA, Laibson PR| title=Punctal plugs in the management of dry eyes. | journal=Ocul Surf | year= 2004 | volume= 2 | issue= 4 | pages= 255-65 | pmid=17216100 | doi= | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=17216100 }} </ref><ref name="pmid12912699">{{cite journal| author=Khodadoust A, Quinter AP| title=Microsurgical approach to the conjunctival flap. | journal=Arch Ophthalmol | year= 2003 | volume= 121 | issue= 8 | pages= 1189-93 | pmid=12912699 | doi=10.1001/archopht.121.8.1189 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=12912699 }} </ref><ref name="pmid14704553">{{cite journal| author=Güerrissi JO, Belmonte J| title=Surgical treatment of dry eye syndrome: conjunctival graft of the minor salivary gland. | journal=J Craniofac Surg | year= 2004 | volume= 15 | issue= 1 | pages= 6-10 | pmid=14704553 | doi= | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=14704553 }} </ref> | ||
Surgical intervention is not recommended for the management of infective conjunctivitis, [[allergic conjunctivitis]], and neonatal conjunctivitis. | |||
==Surgery== | ==Surgery== | ||
===Keratoconjunctivitis Sicca=== | ===Keratoconjunctivitis Sicca=== | ||
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====Lens therapy==== | ====Lens therapy==== | ||
For severe ocular surface disorders in dry eye disease, bandage contact lenses and scleral lenses are available. | For severe ocular surface disorders in dry eye disease, bandage contact lenses and scleral lenses are available. | ||
===Amniotic membrane transplantation=== | ====Amniotic membrane transplantation==== | ||
Amniotic membrane transplantation is used in cases of persistent [[corneal ulceration]] and [[perforation]]. | Amniotic membrane transplantation is used in cases of persistent [[corneal ulceration]] and [[perforation]]. | ||
====Salivary gland duct transposition==== | ====Salivary gland duct transposition==== | ||
Salivary glands have occasionally been transplanted to replace lacrimal glands, but in the long term this led to corneal edema and excessive lacrimation. | Salivary glands have occasionally been transplanted to replace lacrimal glands, but in the long term this led to corneal edema and excessive lacrimation. | ||
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Surgical resection of the involved conjunctiva is not the first-line treatment option for patients with superior limbic keratoconjunctivitis. Amniotic membrane grafting and lens therapy are usually reserved for patients who are not responsive to noninvasive treatment. | |||
Surgery is not the first-line treatment option for patients with [disease name]. [Name of intervention] is usually reserved for patients with | |||
==References== | ==References== | ||
{{reflist|2}} | {{reflist|2}} | ||
Revision as of 19:25, 7 July 2016
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor(s)-in-Chief: Sara Mehrsefat, M.D. [2]
Overview
Despite the availability of efficient tear substitutes, many patients with keratoconjunctivitis sicca (dry eye syndrome) experience severe corneal injuries and a subsequent loss of vision. Surgical techniques include lateral tarsorrhaphy, punctal plugs, lens therapy, amniotic membrane transplantation, and salivary gland duct transposition.[1][2][3][4] Surgical intervention is not recommended for the management of infective conjunctivitis, allergic conjunctivitis, and neonatal conjunctivitis.
Surgery
Keratoconjunctivitis Sicca
Despite the availability of efficient tear substitutes, many patients with keratoconjunctivitis sicca (dry eye syndrome) experience severe corneal injuries and a subsequent loss of vision. Surgical techniques include lateral tarsorrhaphy, punctal plugs, lens therapy, amniotic membrane transplantation, and salivary gland duct transposition.[1][2][3][4]
Lateral tarsorrhaphy
If a person has difficulty closing the eyes for any reason, such as Bell's palsy, the eyes may dry out because of tear evaporation.Lateral tarsorrhaphy is a procedure during which the lateral one-third of the eyelids are sewn together to decrease the ability of the eye to open widely and to help the eyes close more easily.[1]
Punctal plugs
A punctal plug is a small device that is inserted into the tear duct. This prevents the drainage of liquid from the eye. Punctal plugs are often used in the treatment of dry eye syndrome. Available types include absorbable plugs, nonabsorbable plugs, thermoplastic plugs, and hydrogel plugs.[2]
Lens therapy
For severe ocular surface disorders in dry eye disease, bandage contact lenses and scleral lenses are available.
Amniotic membrane transplantation
Amniotic membrane transplantation is used in cases of persistent corneal ulceration and perforation.
Salivary gland duct transposition
Salivary glands have occasionally been transplanted to replace lacrimal glands, but in the long term this led to corneal edema and excessive lacrimation.
=
Surgical resection of the involved conjunctiva is not the first-line treatment option for patients with superior limbic keratoconjunctivitis. Amniotic membrane grafting and lens therapy are usually reserved for patients who are not responsive to noninvasive treatment. Surgery is not the first-line treatment option for patients with [disease name]. [Name of intervention] is usually reserved for patients with
References
- ↑ 1.0 1.1 1.2 Rajak S, Rajak J, Selva D (2015). "Performing a tarsorrhaphy". Community Eye Health. 28 (89): 10–1. PMC 4579993. PMID 26435586.
- ↑ 2.0 2.1 2.2 Baxter SA, Laibson PR (2004). "Punctal plugs in the management of dry eyes". Ocul Surf. 2 (4): 255–65. PMID 17216100.
- ↑ 3.0 3.1 Khodadoust A, Quinter AP (2003). "Microsurgical approach to the conjunctival flap". Arch Ophthalmol. 121 (8): 1189–93. doi:10.1001/archopht.121.8.1189. PMID 12912699.
- ↑ 4.0 4.1 Güerrissi JO, Belmonte J (2004). "Surgical treatment of dry eye syndrome: conjunctival graft of the minor salivary gland". J Craniofac Surg. 15 (1): 6–10. PMID 14704553.