Canadian journal of ophthalmology. Journal canadien d'ophtalmologie · 2012
An improved surgical method to correct conjunctivochalasis: conjunctival semiperitomy based on corneal limbus with subconjunctival cauterization.
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Wang Shun, Ke Min, Cai Xiaojun, Chen Xiaomin, Yu Aihua, Dai Hanjun, Wen Xiaofeng
Аннотация
OBJECTIVE: To introduce an improved surgical method to correct conjunctivochalasis.
DESIGN: Retrospective study.
PARTICIPANTS: We studied 28 eyes in 28 patients.
METHODS: First, conjunctival semiperitomy based on the corneal limbus was performed. Next, the subconjunctival tissues received 2 lines (12 to 18 spots) of gentle cauterization using a cautery to adhere the conjunctiva to underlying sclera. The grade of conjunctivochalasis, Schirmer test (St), and tear breakup time (BUT) were recorded under a slit-lamp, and the severity of patients' symptoms were assessed by using the Ocular Surface Disease Index (OSDI) questionnaires. The values before surgery and 3 months after surgery were collected and then compared.
RESULTS: The conjunctivochalasis gradings were as follows: preoperatively, there were 0 eyes in grade 0 and grade 1; 13 (46.43%) eyes in grade 2; and 15 (53.57%) eyes in grade 3. Postoperatively, there were 26 (92.86%) eyes in grade 0; 2 (7.14%) eyes in grade 1; and 0 eyes in grades 2 and 3. Preoperatively, the St, BUT, and OSDI were 8.49 ± 4.42 mm, 7.74 ± 2.72 seconds, and 40.64 ± 10.30, respectively; postoperatively, they were 13.22 ± 4.26 mm, 12.06 ± 2.48 seconds, and 10.50 ± 3.87, respectively. There was a significant difference (p < 0.05) between pre- and postoperative patients in conjunctivochalasis grade, St, BUT and OSDI.
CONCLUSIONS: Conjunctival semiperitomy combined with gentle subconjunctival cauterization is a better therapy for conjunctivochalasis because it both resects the redundant conjunctiva and reestablishes the anatomic tight adhesion between the conjunctiva and the underlying sclera along the corneal limbus.
DESIGN: Retrospective study.
PARTICIPANTS: We studied 28 eyes in 28 patients.
METHODS: First, conjunctival semiperitomy based on the corneal limbus was performed. Next, the subconjunctival tissues received 2 lines (12 to 18 spots) of gentle cauterization using a cautery to adhere the conjunctiva to underlying sclera. The grade of conjunctivochalasis, Schirmer test (St), and tear breakup time (BUT) were recorded under a slit-lamp, and the severity of patients' symptoms were assessed by using the Ocular Surface Disease Index (OSDI) questionnaires. The values before surgery and 3 months after surgery were collected and then compared.
RESULTS: The conjunctivochalasis gradings were as follows: preoperatively, there were 0 eyes in grade 0 and grade 1; 13 (46.43%) eyes in grade 2; and 15 (53.57%) eyes in grade 3. Postoperatively, there were 26 (92.86%) eyes in grade 0; 2 (7.14%) eyes in grade 1; and 0 eyes in grades 2 and 3. Preoperatively, the St, BUT, and OSDI were 8.49 ± 4.42 mm, 7.74 ± 2.72 seconds, and 40.64 ± 10.30, respectively; postoperatively, they were 13.22 ± 4.26 mm, 12.06 ± 2.48 seconds, and 10.50 ± 3.87, respectively. There was a significant difference (p < 0.05) between pre- and postoperative patients in conjunctivochalasis grade, St, BUT and OSDI.
CONCLUSIONS: Conjunctival semiperitomy combined with gentle subconjunctival cauterization is a better therapy for conjunctivochalasis because it both resects the redundant conjunctiva and reestablishes the anatomic tight adhesion between the conjunctiva and the underlying sclera along the corneal limbus.