Anterior Lamellar Recession With Buccal Mucous Membrane Grafting for Cicatricial Entropion

Purpose: To evaluate the use of anterior lamellar recession with buccal mucous membrane grafting for treatment of cicatricial entropion. Methods: A retrospective interventional case series of 26 patients (35 eyelids) who underwent anterior lamellar recession with buccal mucous membrane grafting for cicatricial entropion. Results: Thirty-five eyelids of 26 patients were treated for moderate to severe cicatricial entropion between 1992 and 2005. The most common underlying etiologies were ocular cicatricial pemphigoid (13 eyelids), blepharitis (7 eyelids), and Stevens-Johnson syndrome (5 eyelids). Treatment was defined as an anatomic success if no keratinized eyelid margin tissue was touching the ocular surface. The success rate of primary repair was 77% (27 of 35 eyelids) with a mean follow-up time of 2.5 +/- 1.9 years. Four eyelids (11%) underwent repeat grafting for recurrent entropion secondary to graft shrinkage (3 eyelids) and graft dislocation (I eyelid) for a cumulative success rate of 89%. The remaining 4 eyelids (11%) had recurrent entropion that was managed surgically with a technique other than repeat grafting. The postoperative complications consisted of I case of wound site infection that was successfully treated with topical antibiotics and I case of mouth wound infection. Overall, there was a reduction in the frequency of patients reporting discomfort/foreign body sensation, tearing, photosensitivity, and pain following treatment. Corneal fluorescein staining improved postoperatively in 66% of eyes, stayed the same in 17%, and worsened in 17%. Conclusions: Anterior lamellar recession with buccal mucous membrane grafting is an effective surgical approach for the treatment of moderate to severe cicatricial entropion. (Ophthal Plast Reconstr Surg 2009;25:180-184)