Surgical treatment of extensive symblepharon with oral mucosa autografting transplantation in two patients with ocular cicatricial pemphigoid

Abstract

AbstractPurposeTο present the surgical management of extensive symblepharon in two cases of advanced ocular cicatricial pemphigoid.MethodsA 68‐year‐old male with ocular cicatricial pemphigoid treated with methotrexate was presenting trichiasis and extensive symblepharon in the left lower eyelid. The second case was a 70‐year‐old woman treated with dapsone and mycophenolate mofetil with extensive symblepharon in her left lower eyelid. In both cases, we harvested oral mucosa autograft and sutured it in the left lower tarsus after surgical dissection of the symblepharon.ResultsIn both cases postoperatively the lower eyelid was mobile, the graft was in place and vivid, no signs of inflammation nor rejection, quiet eye. Three months later there was no scarring of the graft and fornix in the first patient, but some scarring in the second patient as the control of ocular cicatricial pemphigoid was inadequate.ConclusionsOral mucosa autografting transplantation for forniceal reconstruction is a surgical technique that should be considered in patients with symblepharon formation and ocular cicatricial pemphigoid when active disease is controlled.BibliographyKheirkhah A, Blanco G, Casas V, Hayashida Y, Raju VK, Tseng SC. Surgical strategies for fornix reconstruction based on symblepharon severity. Am J Ophthalmol. 2008 Aug;146(2):266‐275. doi: 10.1016/j.ajo.2008.03.028. Epub 2008 Jun 2. PMID: 18514608.