Tissue therapy in parenchymatous xerosis.

PARENCHYMATOUS xerosis has been known for a very long time. Various therapeutic measures have been employed from time to time without any real success. The condition has been regarded as incurable, and DukeElder (1938) states that relief can be obtained only by oily drops. Encouraged by the results of keratoplasty, I decided to try the operation of conjunctivoplasty in the so-called incurable condition of xerosis secondary to trachoma. Sorsby (1948) and Brown (1941) reported good results from the use of specially prepared amniotic membrane grafts in conjunctival burns, but as conjunctiva was at times not available it was decided to transplant amniotic membrane. As an experimental measure a 2-mm. piece of bulbar conjunctiva was removed, and a piece of specially prepared amniotic membrane of similar size was grafted in its place in two cases. The grafts did not take, and the membrane melted away, but surprisingly enough there was marked improvement in the xerotic condition in each case. It was therefore decided to apply the simple procedure of tissue therapy in xerosis. In 1936 Filatov first introduced tissue therapy in retinitis pigmentosa by the implantation of pieces of placenta beneath the subconjunctiva, and reported a certain measure of success (Filatov and Verbitska, 1946). Filatov (1937) also tried tissue therapy in trachomatous pannus. Implantations of preserved cadaver mucous membrane from the lip and conjunctiva led to gratifying results. Implantations of various tissues together with intramuscular injections of cod-liver oil were included among his therapeutic procedures, and he also used vegetable products such as aloe leaves. Saint-Martin (1950) describes the use of vegetable substances by subcutaneous injection and of skin as implant. Beneficial effects have also been reported by Olontzeva and Pokrovsky (1946). In the series here reported, 25 cases have been treated by this procedure and there has been marked improvement in all of them.