Management of Severe Cicatricial Entropion With Labial Mucous Membrane Graft in Cicatricial Ocular Surface Disorders. Issue 6 (September 2018)

• Record Type: Journal Article
• Authors: Osaki, Tammy H.; Sant'Anna, Ana Estela; Osaki, Midori H.; Kikkawa, Don O.; Yabumoto, Cristina; Yang, Patrick; Korn, Bobby S.
• Is Part Of: Journal of craniofacial surgery. Volume 29:Issue 6(2018)
• Publication Date: 2018-09
• Subjects: Cicatricial entropion -- ocular surface disease -- oral mucous membrane -- Stevens–Johnson syndrome -- tarsotomy -- trachoma; Facial bones -- Surgery -- Periodicals; Skull -- Surgery -- Periodicals; Face -- Surgery -- Periodicals; Surgery, Plastic -- Periodicals; 617.52
• DOI: 10.1097/SCS.0000000000004584
• Languages: English
• ISSNs: 1049-2275

Abstract

Abstract : Abstract: The management of cicatricial entropion represents a therapeutic challenge especially when the underlying causes are progressive cicatricial diseases that affect the ocular surface. The authors aimed to report long-term efficacy of labial mucous membrane graft to manage severe cicatricial entropion of the upper eyelid. This study is a retrospective chart review of patients who underwent tarsotomy associated with labial mucous membrane graft to treat severe cicatricial entropion of the upper eyelid. Surgeries were performed over a 16-year period. Clinical data (age, gender, etiology of the cicatricial entropion, improvement of symptoms, eyelid position, recurrence, complications, and follow-up period) were extracted from these patients' charts. Etiology of the cicatricial entropion, improvement of symptoms, eyelid position, recurrence, complications, and follow-up period were evaluated. Sixty-three eyelids from 44 patients underwent surgery. Mean follow-up was 48.4 ± 46.1 months (range 6 months to 15 years). Main underlying diagnoses were Stevens–Johnson syndrome (63%), trachoma (19%), chemical injury (8%), and trauma (5%). Forty-three patients (98%) reported improvement of ocular symptoms after the procedure. Complete resolution (restoration of the upper eyelid margin to normal anatomic position with good esthetic appearance) was achieved in 52 eyelids (83%). Recurrence occurred in 7 (11%) eyelids. No postoperative infection, failure of graft survival, or other complications were observed. The use of labial mucous membrane as a posterior lamella graft showed good functional and cosmetic outcomes, long-term stability and low recurrence rates in the treatment of severe cicatricial entropion of the upper eyelid.