Cicatricial entropion repair with hard palate mucous membrane graft: surgical technique and outcomes

Abstract

The use of a hard palate mucous membrane graft (HPMMG) has been previously described for upper and lower eyelid cicatricial entropion repair. The objective of this paper is to review the surgical technique and postoperative complications in a large series of patient who underwent hard palate grafting for the management of cicatricial entropion. The medical records of 107 patients representing 147 eyelids undergoing surgical management of cicatricial entropion with HPMMG were reviewed. The surgical technique is described. 147 eyelid operations (74 upper, 73 lower) were performed on 107 patients (46 male, 61 female), with a mean age of 63 years (range 12-87). The aetiology of the cicatricial entropion included idiopathic (41%), trauma (5.6%), chronic blepharitis (16.8%), chemical injury (3.7%), ocular cicatricial pemphigoid (8.4%), trachoma (7.5%) and other (16.8%). Patients were followed postoperatively for an average of 21 months (range 6-120). Ninety-four per cent of patients noted symptomatic improvement. The postoperative complications included excess keratin (29%), recurrence of cicatricial entropion (4.1%), punctuate epithelial erosion (2.7%), graft shrinkage (0.7%) and donor site bleeding (2.0%). Cicatricial Entropion with hard palate mucous membrane grafting for both upper and lower eyelid surgery offers high symptomatic and anatomical cure rates. The requirement for further surgical intervention is low.