Novel Technique to Control Hypersecretion From a Transplanted Autologous Submandibular Salivary Gland for Keratoconjunctivitis Sicca

PURPOSE:To present a novel technique to control hypersecretion from a transplanted autologous submandibular gland (SMG) in a patient with keratoconjunctivitis sicca. METHODS:A 65-year-old man presented with corneal epithelial edema and suspicious ocular surface dysplasia secondary to hypersecretion from a transplanted autologous SMG. The location and function of the gland were evaluated perioperatively using technetium-99m-pertechnetate scintigraphy. The course of the duct was marked with a radiation probe, surgically exposed, and partially ligated with titanium clips. RESULTS:Marked reduction in salivary flow and resolution of corneal edema and ocular surface changes were noted. Conjunctival biopsy showed no evidence of malignancy. Symptoms were stable during a 1-year follow-up period. CONCLUSION:Partial ligation of the transplanted SMG duct may be a simple and reversible technique to control hypersecreting glands with secondary corneal edema and ocular surface changes.