Posterior lamellar eyelid reconstruction with acellular dermis allograft in severe cicatricial entropion.

Severe cicatricial entropion is a serious condition, which may threaten the vision of the affected patient. To date, surgical repair of this condition has been difficult and associated with a high degree of failure. From February 2005 to February 2006, a prospective cohort study was conducted in which 14 patients with severe cicatricial entropion were recruited. Lengthening of the posterior lamella of the eyelid with acellular dermis allograft (ReDerm, Jieya company, Beijing, PR China) was performed followed by use of therapeutic contact lenses at the end of surgery. The patients were followed up regularly and were assessed for structural integrity, upper marginal reflex distance (U-MRD), vertical palpebral aperture, and lagophthalmos. The mean follow-up time was 18 months. Acellular dermis was effective in reducing the palpebral aperture (P = 0.002), lagophthalmos (P = 0.016), and lengthening the upper eyelid height by reducing U-MRD (P = 0.008). However, there were 2 cases of recurrence because of the shrinkage of graft (70%) and 3 cases of conjunctival granulomas postoperatively. Final outcome was good in 14 of 16 eyelids. We have found that acellular dermis grafting with insertion of therapeutic contact lenses is an effective and simple measure for rectifying severe cicatricial entropion both structurally and functionally.