Anterior lamellar repositioning and grey line split for upper lid entropion in ocular cicatricial pemphigoid

Eye
M J Elder, R Collin

Abstract

Trichiasis in ocular cicatricial pemphigoid (OCP) is usually due to cicatricial entropion and is a major cause of ocular morbidity. Unfortunately in this disease, direct surgery on the conjunctiva often results in marked inflammation and cicatrisation. This paper assessed a procedure that corrects cicatricial entropion of the upper lid while avoiding surgery to the conjunctiva. A grey line upper lid split and a vertical anterior lamellar repositioning was performed on 16 lids of 11 patients with OCP. Anatomical success was achieved in 72% of lids at 1 year and 61% had complete success with no lashes touching the globe. These outcomes were maintained up to 4 years. There were no perioperative complications. Two patients post-operatively developed severe conjunctival inflammation that required systemic immunosuppression. The causes of failure were primary surgical failure (n = 2), progression of cicatrisation secondary to surgically induced inflammation (n = 1), development of misdirected lashes (n = 1) and late recurrence at 7 months (n = 1). One patient developed peaking of the eyelid. This procedure has a good long-term outcome with minimal complications. Activation of severe conjunctival inflammation occurred in 13% of cases ...Continue Reading

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Citations

Jan 9, 2014·Ophthalmic Plastic and Reconstructive Surgery·Youn Joo ChoiSang In Khwarg
Jun 27, 2001·Ophthalmology·S E TiS P Chee
Nov 14, 2001·Clinics in Dermatology·L S Chan
Sep 11, 2008·The Ocular Surface·Valerie P J Saw, John K G Dart
Mar 27, 2002·International Ophthalmology Clinics·Phillip H Choo
Apr 29, 2015·Journal of Ophthalmology·Rania A Ahmed, Sameh H Abdelbaky
May 21, 2009·Ophthalmic Plastic and Reconstructive Surgery·Irina V KoreenVictor M Elner
Oct 24, 2008·Journal of Plastic, Reconstructive & Aesthetic Surgery : JPRAS·Y L BiA Rong
Sep 7, 2007·Acta Ophthalmologica·Sang Won HwangHo-kyung Choung
Aug 9, 2011·Clinical & Experimental Ophthalmology·Adam H RossRaman Malhotra
Nov 20, 2016·Ophthalmic Plastic and Reconstructive Surgery·David J Russell, Stuart R Seiff
Jul 3, 2018·Current Opinion in Ophthalmology·Mostafa M DiabAhmed S Saif
Jan 30, 2019·Ophthalmology and Therapy·Panagiotis GeorgoudisZisis Gatzioufas

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