367 Entropion repair outcomes in ocular cicatricial pemphigoid versus other cicatricial etiologies: A retrospective study

Abstract

Mucous membrane pemphigoid with ocular involvement or ocular cicatricial pemphigoid (OCP) can lead to severe eyelid disease, including entropion. Surgical repair outcomes of OCP-related entropion compared to other cicatricial entropion has yet to be elucidated. This study aims to understand the association between entropion recurrence and diagnosis of OCP. Entropion repair of OCP patients were compared to patients with entropion of other cicatrizing etiology from January 2010 to June 2020. A generalized estimating equation with binomial likelihood and logit link was used to analyze the association between a diagnosis of OCP and failure of the first entropion repair, determined by recurrence or repair noted. Patient ID was used as the clustering variable with exchangeable correlation structure.19 OCP patients and 60 patients with entropion secondary to other etiologies received 38 and 75 entropion repairs, respectively. The unadjusted odds of failure did not significantly differ between groups (odds ratio (OR) 2.66, 95% confidence interval (CI) 0.92-7.69). No significant effect of OCP diagnosis was found (OR: 2.43, 95% CI: 0.75-7.87) when adjusting for age at repair, sex, repair approach, ophthalmologic steroids, and non-steroidal ophthalmologic immunosuppressants (systemic steroids and non-steroidal immunosuppressive agents were highly correlated with OCP diagnosis and removed from the model). Age at first repair was positively associated with failure (p=0.026). Ophthalmic steroids use decreased the odds offailure (OR: 0.27 95% CI: 0.07-0.96). This study provides evidence that in a population of OCP patients where the majority were systemically immunosuppressed, the likelihood of entropion failure was no different than that for repair of entropion secondary to other cicatrizing etiologies.