Results of buccal mucosal grafting for patients with medically controlled ocular cicatricial pemphigoid.
Eyelid surgery for patients with ocular cicatricial pemphigoid is risky when there is unchecked perioperative inflammation. The authors performed buccal mucosal grafts on 42 eyelids (23 eyes) of 17 patients with ocular cicatricial pemphigoid whose disease was controlled by systemic immunosuppression. Results were graded as: improved (12 cases, 16 eyes); satisfactory (2 cases, 2 eyes); or poor (5 patients, 5 eyes). Complications included breakthrough trichiasis, surface keratinization of the graft, blepharoptosis, phimosis, depressed eyelid blink, incomplete eyelid closure, submucosal abscess formation, and persistent nonhealing epithelial defects of the cornea. Technical errors at surgery accounted for two complications. Secondary corneal ulceration developed in two patients. The immunologic aspect of the disease flared or progressed in five patients in the postoperative period and necessitated an increase or change in systemic medication for immunosuppression. Buccal mucosal grafting shows promise in temporarily rehabilitating eyelids of some ocular cicatricial pemphigoid patients whose disease is controlled by immunosuppressive therapy.
Shore
J W
JW
Department of Ophthalmology, Massachusetts Eye and Ear Infirmary, Harvard Medical School, Boston 02114.
Foster
C S
CS
Westfall
C T
CT
Rubin
P A
PA
D005141:Eyelid Diseases / Q000188:drug therapy / Q000276:immunology / Q000601:surgery*; D005143:Eyelids / Q000637:transplantation; D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use; D009061:Mouth Mucosa / Q000637:transplantation*; D010390:Pemphigoid, Benign Mucous Membrane / Q000188:drug therapy / Q000276:immunology / Q000601:surgery*; D011183:Postoperative Complications; D016896:Treatment Outcome
D007166:Immunosuppressive Agents