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Oral mucosal grafts beneficial in incomplete closure, lid margin keratinization
Am J Ophthalmol. 2011;152(4):600-608
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Use of oral mucosal grafts can help prevent further deterioration of the ocular surface related to lid margin keratinization, trichiasis or distichiasis, according to a study. The grafts also can help in cases of exposure caused by cicatricially induced incomplete closure.
The analysis retrospectively examined medical records of 22 eyes and 39 eyelids from 19 consecutive patients with a mean age of 45.7 (range: 6 to 80 years) who underwent an oral mucosal graft during lid margin reconstruction from September 2007 through February 2010. Mean follow-up period was 16.2 months.
In 10 eyes with lid margin keratinization, trichiasis or distichiasis, the graft corrected the issue fully in six eyes, while the issues with trichiasis in three eyes and distichiasis in one eye were away from the corneal surface, according to the study. In the 12 eyes with incomplete closure, the problem was completely corrected in nine eyes and improved in three eyes.
Analysis showed visual acuity improved in 13 eyes and remained the same in eight eyes, while conjunctival inflammation was reduced in 19 eyes. Visual acuity was worse in one eye due to progressive inflammation from severe dry eye.
"We advocate that patients with the aforementioned lid margin pathologic features be corrected promptly with measures including oral mucosal graft to avoid progressive and permanent damage leading to chronic inflammation, scarring and even limbal stem cell deficiency," the study authors wrote.
The analysis was limited by the study's retrospective and noncomparative design and by the small number of cases.