J Korean Ophthalmol Soc.  2008 Jul;49(7):1177-1182. 10.3341/jkos.2008.49.7.1177.

A Case of Ocular Surface Reconstruction Using Nasal and Oral Mucosa Autograft

• Lee SH
• Kim JH
• Kim JT
• Chun YS
• Kim JC

• KMID: 1476975
• DOI: http://doi.org/10.3341/jkos.2008.49.7.1177

Abstract

PURPOSE
To report a case of ocular surface reconstruction using nasal and oral mucosa auto grafts on a man whose ocular surface was deformed by a chemical burn.
CASE SUMMARY
A 48-year-old man was injured when his right eye was exposed to alkali solution. He underwent fifteen operations, including amniotic membrane auto grafts and fornix reconstructions. However, his right eye still suffered from symble pharon, drying, corneal neovascularization, and erosion. We performed ocular surface reconstruction with free autologous nasal and oral mucosal transplantation and amniotic membrane graft. By one month after surgery, his eye showed no evidence of symble pharon or fibrovascularization recurrence on the cornea or conjunctiva. By six months after surgery, his ocular surface had stabilized.
CONCLUSIONS
Ocular surface reconstruction with free autologous nasal and oral mucosal transplantation is a useful method on eyes that are injured by chemical burns.

Keyword

Chemical burn; Nasal mucosa; Ocular surface reconstruction; Oral mucosa

MeSH Terms

Alkalies
Amnion
Burns, Chemical
Conjunctiva
Cornea
Corneal Neovascularization
Eye
Humans
Middle Aged
Mouth Mucosa
Nasal Mucosa
Recurrence
Transplants
Alkalies

Figure

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  Figure 1. The eye with upper and lower symblepharon, fibrovascular tissue on the cornea and conjunctiva, the total limbal deficiency.

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  Figure 2. At one month after surgery. (A) There was well formed conjunctival sac without recurrence of symblepharon. (B) There was no corneal epithelium defect.

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  Figure 3. Conjunctival biopsy stained with periodic acid-Schiff (×400), (A) Pre-operative biopsy shows squamous metaplasia. (B) At one month after surgery, conjunctival biopsy shows mucin secreting goblet cells. (arrow)

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  Figure 4. At six months after surgery, (A) His ocular surface was stabilized without recurrence of symblepharon. (B) Mucin secretion at part of nasal mucosa autotransplantation.

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  Figure 5. Nasal mucosa stained with periodic acid-Schiff (×100). Numerous epithelial and submucosal goblet cells. (arrow)

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  Figure 6. Oral mucosa stained with periodic acid-Schiff (×100). No goblet cell at epithelium.

Reference

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