Oral abstract presentation times
11th Rapid Fire
11th Oral
Abstract ID: 26-611
Oculoplastic Surgery in Cicatrising Conjunctivitis: Patterns of Lid Malposition and Trichiasis in a Large Tertiary Cohort
Author: Andréa Poupard Base Hospital / Institution: Birmingham and Midlands Eye Center
Presentation Type: Oral Presentation Session: Eyelid Cosmetic & MiscellaneousDate: 11th SeptemberTime: 11.15
Purpose
Cicatrising conjunctivitis (CC), most commonly ocular mucous membrane pemphigoid (OcMMP), causes progressive conjunctival scarring, cicatricial lid malposition and ocular surface failure. Disease control with systemic immunomodulatory therapy is central, yet oculoplastic surgery is frequently required and must be planned to minimise conjunctival trauma. We describe the spectrum of CC and oculoplastic interventions in a UK tertiary centre.
Methods
Retrospective single centre review of all CC patients attending a tertiary ocular surface disease service. Demographics, deprivation, ethnicity, diagnosis and oculoplastic procedures were descriptively analysed.
Results
We identified 383 patients (59% female), mean age 70 years (SD 15.7); 88% were White British and the median Index of Multiple Deprivation centile was 4 (IQR 2–7). Diagnoses were: OcMMP 236 (61.6%), unconfirmed 55 (14.4%), drug induced cicatrisation 25 (6.5%), post viral 13 (3.4%), rosacea 11 (2.9%) and other 43 (11.2%). In total, 161 procedures were performed in 137 patients; redo surgery (n=7) occurred only for entropion and almost exclusively in OcMMP. Among surgical patients, lid procedures were undertaken in 41% of OcMMP, 24% unconfirmed, 24% drug induced, 31% post viral, 36% rosacea and 21% other CC. Overall, lid malposition procedures accounted for 68.3% of operations, trichiasis 13.7%, reconstructive procedures 4.3%, punctal narrowing 3.8%, tear retention 4.4%, ocular surface protection 3.1% and incidental procedures 3.7%.
Conclusion
In this large tertiary CC cohort, disease was predominantly OcMMP in older, socioeconomically deprived patients. Oculoplastic workload was dominated by cicatricial lid malposition and trichiasis, with repeat surgery confined to entropion, underscoring the central role of mechanical ocular surface protection alongside systemic disease control.
Additional Authors
| First name | Last name | Base Hospital / Institution |
|---|---|---|
| Aden | Yin Tong Siu | Birmingham and Midlands Eye Center |
| Gibran | Butt | Birmingham and Midlands Eye Center |
| Saaeha | Rauz | Birmingham and Midlands Eye Center |