[Transplantation of autologous oral mucosa in the treatment of a symblepharon in Wegener's disease--a case report].
BACKGROUND
Wegener's disease, an immune vasculitis, is characterized by granulomata and vasculitis of small and large vessels. Ocular manifestations are observed in approximately half of all cases.


METHODS
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 nervous system became clinically manifest by a stroke, of the kidneys by incipient renal insufficiency, and of the larynx by recurrent subglottic stenosis of the trachea. The first ocular involvement, a conjunctivitis, was observed in 1988. Despite systemic immuno-suppressive therapy, local conservative therapy and repeated surgical procedures, his vision decreased bilaterally from 60/60 to hand movement (OD) and light perception only (OS) during the following years because of a massive bilateral symblepharon. Transplantation of autologous oral mucosa to the conjunctiva led to a persistent increase 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.
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Augenklinik Charité, Campus Virchow-Klinikum der Humboldt Universität zu Berlin, 13344 Berlin.
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D003229:Conjunctival Diseases / Q000209:etiology / Q000601:surgery*; D014890:Granulomatosis with Polyangiitis / Q000150:complications*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009061:Mouth Mucosa / Q000637:transplantation*; D017060:Patient Satisfaction; D014182:Transplantation, Autologous; D016896:Treatment Outcome; D014792:Visual Acuity
Schleimhautplastik mit autologer oraler Mukosa zur Therapie des Symblepharon bei Morbus Wegener--eine Kasuistik.