An improved surgical method to correct conjunctivochalasis: conjunctival semiperitomy based on corneal limbus with subconjunctival cauterization.

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.