AUTOLOGOUS NASAL-MUCOSA TRANSPLANTATION A FTER SEVERE CHEMICAL AND THERMAL EYE BURNS

Background Extensive conjunctival scarring is common after severe chem ical and thermal eye burns. There is often not enough healthy conjunct iva from the other eye available to correct the symblepharons, therefo re other autologous tissues have to be transplanted. Patients and meth ods From February 1992 until March 1993 13 patients were treated with free nasal mucosal grafts from the inferior turbinates for reconstruct ion of the fornices. The newly created deep fornices were secured by a silikone band. In 3 patients an Illig plastic shell was used addition ally. The surgical treatment was supplemented with an intensive treatm ent with topical corticosteroids to decrease the inflammatory reaction . Results The patients were followed for an average of 7-18 months. Th e intervall between the accident and the transplantation ranged from 2 -26 months. In 10 patients a reconstruction of the fornices was achiev ed. In all patients, however, some slight scares could be observed. Po stoperative Schirmertest was markedly improved. These results encourag e us to plan a penetrating keratoplasty in 7 cases. 3 patients showed a recurrence of the symblepharon 2 months after the transplantation. C onclusion The nasal mucosa graft material is best suited for repair of extensive symblepharon. The advantages of this tissue are the availab ility of large pieces of mucosa and the transplantation of intraepithe lial goblet-cells. Longterm effects are the improvement and stabilisat ion of the tear film.