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J. Kim, J. Kim, Y. Chun; Goblet Cell Transplantation Using Nasal Mucosa in Cicatrical Ocular Surface Disease. Invest. Ophthalmol. Vis. Sci. 2008;49(13):6054.
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To investigate the possibility of replacing the metaplastic ocular surface with nasal mucosa which contains a lot of goblet cells and enriched vascularization. To compare the results of transplantation of oral mucosa and nasal mucosa in cicatrical ocular surface disease.
3 patients with severe recurrent pterygium of the eyes, and 6 patients with chemical burns to the eyes which were characterized by devastated cicatrical metaplasia, symblepharon, fibrous vascular proliferation, corneal opacity, and limbal deficiency were included in this study. The excision of pterygium, symblepharolysis, and the removal of fibrous vascular tissue was performed. After that, nasal mucosa autografts (or oral mucosa autografts) with amniotic membrane transplantations and limbal autografts were performed on bare sclera or the whole cornea over the perilimbal sclera.
There was no recurrence of pterygium and symblepharon in all 9 patients. Well formed conjunctival fornix and stable ocular surface were maintained. There was abundant vascularization to support the limbal grafts and increased mucin secretion which is needed for the ocular surface maintenance, while there were poor epithelization and ischemic changes on some oral mucosal autografts.
The goblet cell transplantation with enriched vascularized nasal mucosa was found to be a very effective method of treatment for cicatrical metaplastic ocular surface disease. The nasal mucosa also found to be more effective than the oral mucosa for ocular surface reconstruction, especially on the conjunctival surfaces.
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