Therapy of a symblepharon in Wegener's disease by transplantation of autologous oral mucosa - a case report

Background: Wegener's disease, an immune vasculitis, is characterized by gr anulomata and vasculitis of small and large vessels. Ocular manifestations are observed in approximately half of all cases. Patient: We report on a 58-year-old male with severe generalized Wegener's disease which was first diagnosed in 1986. The involvement of the central n ervous system became clinically manifest by a stroke, of the kidneys by inc ipient renal insufficiency, and of the larynx by recurrent subglottic steno sis of the trachea. The first ocular involvement, a conjunctivitis, was obs erved in 1988. Despite systemic immuno-suppressive therapy, local conservat ive therapy and repeated surgical procedures, his vision decreased bilatera lly from 60/60 to hand movement (OD) and light perception only (OS) during the following years because of a massive bilateral symblepharon. Transplant ation of autologous oral mucosa to the conjunctiva led to a persistent incr ease of vision and a good cosmetic result. Conclusions: We conclude that in patients with Wegener's disease, who have developed a symblepharon despite intensive therapy, the transplantation of oral mucosa can produce a sufficient functional and cosmetic result.