RECTAL MUCOUS MEMBRANE GRAFT IN DRY EYE
(This paper has won COL. RANGACHARI AWARD at AIOS conference Chandigarh & also published in IJO June 1999.)

In S. J. Syndrome & chemical burn the main problem is mucin deficiency because of destruction of conjunctival goblet cells, which secrete mucin. To replace this I am doing rectal mucous membrane graft in these patients. Why to use rectal mucous membrane only ? Because it is studded with goblet cells. The buccal mucous membrane does not contain goblet cells
In this procedure rectal mucous membrane of the patient is obtained with the help of general surgeon. Patient is operated under spinal anaesthesia. The mucous membrane is obtained from posterior wall of rectum. Nearly 3 cm x 12 cm is sufficient

 

 

The conjunctiva is incised in lower & upper fornix. To the free edges of conjunctiva the rectal mucous membrane of 3 cm x 3 cm is sutured. (see fig. 4) Fornix deepening sutures are taken ( as in any other shallow fornix repair surgery ) This gives continuous source of mucin. The results of this procedure are quite encouraging

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