Schirmer test in transplanted submandibular gland: influencing factors and a modified measurement method.

PURPOSE: To explore a modified Schirmer test for patients with submandibular gland (SMG) transplant. METHODS: Thirty-seven patients (39 eyes) with severe keratoconjunctivitis sicca who underwent SMG transplantation in an institutional setting were included. Schirmer test I was performed on each eye under 4 different conditions: (1) Basal condition: a single test at 23°C room temperature after 30 minutes of rest (ST1 results); (2) Physical activity: 6 consecutive tests 0 to 30 minutes after stair climbing (ST2-ST7 results in a time sequence); (3) Glandular massage: 5 consecutive tests 0 to 25 minutes after glandular massage (ST8-ST12 results in a time sequence); and (4) High temperature: a single test at 30°C room temperature (ST13 results). The main outcome measurement was value of Schirmer test. RESULTS: Compared with the basal condition (median ST1 score was 23 mm), physical activity produced increased ST scores within the first 20 minutes (median ST2 to ST5 scores were 73, 69, 39, and 34 mm, respectively, P 0.05). CONCLUSIONS: A basal condition without physical activity or glandular stimulation at a comfortable and stable room temperature could be considered a standardized condition for Schirmer test for patients with SMG transplant.