Dr. Clara Chan discusses the surgical treatment of advanced ocular cicatricial pemphigoid (OCP), also commonly known as mucous membrane pemphigoid. It typically results in relentless conjunctival inflammation and cicatricial changes. Surgical therapy requires control of conjunctival inflammation with systemic immunosupression treatment. Dr. Chan recommends a staged management algorithm to manage these difficult eyes. Although some patients have reasonable visual recovery, current surgical options for OCP still have guarded to poor prognosis.