Autologous transplantation of nasal mucosa after severe chemical and thermal eye burns.

Between February 1992 and March 1994, reconstruction of the fornices in 17 patients with extensive symblephara or lid fusion after most severe eye burns was performed with nasal mucosa from the inferior conchae as graft material. The time between accident and transplantation ranged from 2-64 months. All patients were followed for 6 to 31 months. Reconstruction of the fornices was achieved in 13 patients. Postoperative Schirmer-tests revealed markedly improved results. Impression cytology showed a persistence of goblet-cells and an excess of mucus. We have subsequently performed keratoplasties in 5 of these patients and are planning penetrating keratoplasties in a further 8 cases. In 4 patients, partial symblepharon formation recurred within 2-3 months after transplantation of nasal mucosa. The main advantage of nasal mucosa over buccal or labial mucosa may be the transplantation of intraepithelial goblet cells, leading to an improvement and stabilisation of the tear film.