Anterior lamellar excision and laissez-faire healing for aberrant lashes in ocular cicatricial pemphigoid.

PURPOSE: To describe the outcomes of a simple technique of anterior lamellar excision (ALE) with laissez-faire healing for management of aberrant lashes in ocular cicatricial pemphigoid (OCP).

METHODS

Prospective interventional case series.

RESULTS

Seven OCP patients underwent grey line split and ALE with laissez-faire healing over a 24-month period in a tertiary referral centre. All patients had undergone previous interventions for the misdirected lashes. Nine procedures were undertaken (three upper and six lower lids). Mean follow-up was for 25.66+/-12.3 months (range: 9-43 months). Residual lashes were noted in three patients. In two cases, the lashes were isolated and managed successfully by a single electrolysis treatment. One patient needed further ALE for residual remnant of trichiatic cilia at the lateral edge of the lid. All patients were satisfied with their post-operative appearance. None of the patients showed exacerbation of disease or needed additional immunosuppression as a consequence of the lid surgery.

CONCLUSIONS

Anterior lamellar excision with spontaneous granulation is a simple and effective procedure for management of aberrant lashes. Risk of disease exacerbation was reduced in OCP with minimal conjunctival manipulation and reduced post-operative lash-globe touch.