To the Editor.
—An 80-year-old woman who had facial diplegia, hypertension, Sjögren's syndrome, arthritis, corneal hypoesthesia, and chronic purulent staphylococcal conjunctivitis was unsuccessfully treated with tear substitutes and antibiotics, but her conditions resolved promptly after conjunctival transplantation.This patient experienced multiple abnormalities of the lacrimal system, including a deficiency in aqueous production as measured by repeated Schirmer's tests and rapid tear breakup, hypoesthesia, and chronic epitheliopathy (ie, extensive punctate keratitis and chronic purulent conjunctivitis). The staphylococcal conjunctivitis was so marked that the tenacious secretions could not be irrigated from the conjunctival surface, but they were removed mechanically without the need of topical anesthesia. No symblepharon ever formed.The bacteria were sensitive to several antibiotics, including chloramphenicol, erythromycin, sulfacetamide sodium, and gentamicin sulfate, that were used at various times without success. In addition, multiple tear substitutes and ointment were employed.After more than one year of chronic recurrent infection, a superficial
Brothers DM. Full-Thickness Mucous Membrane Transplant for Severe Keratitis Sicca. Arch Ophthalmol. 1983;101(3):485-486. doi:10.1001/archopht.1983.01040010485037