INFERIOR RETRACTOR PLICATION SURGERY FOR LOWER LID ENTROPION WITH TRICHIASIS IN OCULAR CICATRICIAL PEMPHIGOID

Aims-To assess the outcome of inferior retractor plication surgery for lower lid entropion in patients with ocular cicatricial pemphigoid (O CP). This technique avoids surgery on the conjunctiva that can result in exacerbations of disease activity. Methods-This prospective study a ssessed the outcomes of a standard 'Jones' type plication in 14 lids o f 10 patients with OCP. Seven patients were taking systemic immunosupp ression and no patients had conjunctival inflammation for the 4 months before surgery. Results-Life table analysis showed a 77% chance of an atomical success at 2 years and a 54% chance of completely preventing lash-globe touch. The surgery did not cause clinical activation of con junctival 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 m isdirected lashes that touched the globe. Conclusion-This technique gi ves good anatomical success over long periods and is particularly safe when there is no conjunctival inflammation present before surgery.