Inferior retractor plication surgery for lower lid entropion with trichiasis in ocular cicatricial pemphigoid.
OBJECTIVE
To assess the outcome of inferior retractor plication surgery for lower lid entropion in patients with ocular cicatricial pemphigoid (OCP). This technique avoids surgery on the conjunctiva that can result in exacerbations of disease activity.


METHODS
This prospective study assessed the outcomes of a standard 'Jones' type plication in 14 lids of 10 patients with OCP. Seven patients were taking systemic immunosuppression and no patients had conjunctival inflammation for the 4 months before surgery.


RESULTS
Life table analysis showed a 77% chance of anatomical success at 2 years and a 54% chance of completely preventing lash-globe touch. The surgery did not cause clinical activation of conjunctival inflammation or other complications. Anatomical failure was primary (n = 2) and due to late cicatrisation (n = 1). Three further cases had restoration of normal anatomy but the patients had persistently misdirected lashes that touched the globe.


CONCLUSIONS
This technique gives good anatomical success over long periods and is particularly safe when there is no conjunctival inflammation present before surgery.
Moorfields Eye Hospital, London.
M J
MJ
Elder
J K
JK
Dart
R
R
Collin
D000368:Aged; D000369:Aged, 80 and over; D004774:Entropion / Q000601:surgery; D005140:Eyelashes / Q000601:surgery*; D005141:Eyelid Diseases / Q000601:surgery; D005260:Female; D006801:Humans; D008297:Male; D010390:Pemphigoid, Benign Mucous Membrane / Q000601:surgery*; D011183:Postoperative Complications / Q000209:etiology; D011446:Prospective Studies; D016896:Treatment Outcome