Oral Mucosal Grafts: Old Technique in New Light

Purpose: To present an update on indications and efficacy of oral mucosal grafts in the clinical management of ocular surface diseases focusing on the new developments of the last 5 years. Methods: Pubmed research on the databases of the years 2007 up to 2012 for the key words mucous membrane graft and eye, fornix reconstruction, eyelid reconstruction, and conjunctival replacement. Results: Well-documented clinical indications for oral mucosal grafting to the ocular surface include correction of restricted socket syndrome, ocular adnexal reconstruction after tumor resection, cicatricial ocular surface diseases and therapy-refractory pterygia. New indications are conjunctival insufficiency after filtrating glaucoma surgery and the combination of mucosa and amniotic membrane grafting for fornix reconstruction. Moreover, different strategies for ex vivo mucous epithelial cell expansion are under discussion. Conclusions: Oral mucosal grafting is a viable option for the replacement of the conjunctiva. Advantages include easily accessibility of grafts in sufficient size even for repeated procedures and a high stability of the grafts. On the other hand, nasal mucosal grafts are superior for some indications due to the lack of goblet cells in the oral mucosa.