Autologous Nasal Mucosa Transplantation in Severe Bilateral Conjunctival Mucus Deficiency Syndrome

From 1984 to 1989, 24 patients with desperate ocular surface wetting problems due to mucus deficiency syndrome with extensive symblephara or lid fusion were treated by autologous free transplants of nasal mucosa from the nasal conchae. This procedure covers the ocular surface not only with nonkeratinizing epithelium but also with goblet cells and produces a mucus layer. This was proven by biopsy in three patients after 1 to 3 years. In all of the patients, conjunctival transplants were not available. Pronounced relief of pain and modest visual improvements are achieved with this procedure, and free autologous nasal mucosal grafts appear to be superior to buccal mucosa in reestablishing the anterior ocular surface. The authors recommend the technique for all patients with massive and otherwise intractable symblephara following lye burns.