Dry Eye Natural Treatment
Lacritin: hope for patients with dry eye?
The problem of dry eye is one of the most common diseases in the daily practice of an ophthalmologist. It is assumed that about 14% of the population have dry eyes, to some extent. This means that even for a small country like Belgium and we are talking about 1.5 million "patient." Coordinated by Prof. Dr. Juan Murube in 2005, a group of international experts in public the Dry Eye "triple classification dry eye for practical clinical use. "Illustrating the many possible causes of dry eyes. However, in A major part of therapy for dry eyes is limited to prescription certain artificial tears. Sometimes patients are encouraged to use an ointment at night. In resistant cases, with a silicone plug "burnout" can be put in the tear duct to limit the outflow of tears into the nose. Or explain to the patient eye dry eyes are "only" a phenomenon aging that we have to accept …
For severe cases Murube Prof. developed a surgical treatment are transplanted lip salivary glands lower tarsal conjunctiva (inner eyelids). In fact, it was discovered that the composition of the secretion of these glands is very similar to tears natural. Moreover, it has been shown by histological studies that even in patients with Sjogren's syndrome, which also has a dry mouth in most cases, the salivary glands are not involved in the degeneration and keep working!
The surgery is relatively simple and can be compared with the transplant the oral mucosa, a surgical procedure often performed in reconstructive surgery of the eyelid. Of course, when transplanted glands, innervation normal gland is interrupted. However, basal glands continues and seems to be enough to offset the loss of function of the tear gland. I slightly modified the technique so far and the teacher 27 transplants were performed Murube myself. Results were published in a book in collaboration with the very Professor and Professor Gerd Geerling Murube University of Würzburg (Germany).
In all patients notice an improvement after the surgery, which ranging from "mild subjective improvement in" on one side and patients who can not stop all artificial tears on the other side. Prof. Murube attributed the improvement to content mucin secretion higher in transplanted glands compared with tears. This theory could explain why the tear quality (measured with, but for experts) improving but the amount is sometimes the same (no improvement in the Schirmer test). That is evident not only clinical but also for the excellent scientific results of the surgery, we compared the natural tears and saliva from labial salivary glands with Peptidomics Technology, University Technology Delft (Prof. Dr. Peter Verhaert). One of the small proteins (peptides) that is found both in tears and saliva is Lacritin. And that was the beginning a collaboration with Professor Laurie Gordon of the University of Virginia in the United States because it is the world leader in the research consortium that studies the Lacritin Lacritin role in dry eye.
Lacritin is a small protein that appears to play an important role in the problem of dry eyes.
A tear is not natural "water", but a complex cocktail of different components. The lacrimal gland secretes an aqueous solution, mucins in the conjunctiva and between tabs various glands to produce various types of lipids. All these elements are essential and we have strong evidence that positive effects Lacritin not only in the lacrimal gland, but also in the mucin-secreting glands of the conjunctiva and the secretion of lipids, called meibomian glands. It believes that one of the main causes of dry eye can be a lack of production and / or secretion of lacritin. The first test of the administration Lacritin of animals dry eyes are very promising. Moreover, even in cases in which the lacrimal gland is not working, he began working again after the injection of Lacritin in the gland.
But Lacrtin not yet available as a drop or injection or anything else, we must work with other therapies.
In this context, we are very happy to find scientific evidence that salivary gland transplantation lip We do not secrete Lacritin. However, further studies should performed before transplantation of the salivary glands can be considered "common" surgical treatment for dry eyes.
Dr. Peter Raus
About the Author
Dr. Peter Raus is an internationally known Belgian oculoplastic surgeon ‘Miró’ center for ophthalmology, oculoplastic surgery and aesthetic medicine in Mol, Belgium. Peter already gave lectures on oculoplastics and skin surgery in 23 different countries and is the inventor of the Raus/Garito clamp for ectropium surgery. Dr. Raus is columnist for the magazine ‘Living in Style’
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