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Ari Shinojima, Mitsuko Yuzawa; Conjunctiva fixation to the posterior sclera for the treatment of conjunctivochalasis. Invest. Ophthalmol. Vis. Sci. 2015;56(7 ):3033.
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There are reports describing operative techniques for conjunctivochalasis with and without resection of the conjunctiva. If there is excessive conjunctival tissue, it is difficult to attach 8-0 Vicryl® thread (Johnson & Johnson, NJ, USA) directly at the site 8 mm posterior to the corneal limbus, as in the previously reported method (Otaka and Kyu, Am J Ophthalmol, 2000). Therefore, we endeavored to develop a simple non-resection surgical technique for conjunctivochalasis with simultaneous conjunctival tacking.
Patients over 60 years of age who had been diagnosed with conjunctivochalasis were enrolled in this study. The mean age (±SD) of our patients was 77.1 ± 5.9 years (range, 64-83 years). In total, 23 eyes of 14 patients (3 men, 5 eyes; 11 women, 18 eyes) underwent operative treatment of conjunctivochalasis. Topical anesthetic eye drops including 0.4% oxibuprocaine and 4% lidocaine were instilled. The lower bulbar conjunctiva was initially scooped 4mm posterior to the corneal limbus, and stitches were then fixed with careful tacking 8 mm posterior to the corneal limbus, in order to avoid restriction of the lower gaze. We used 8-0 Vicryl® for the stiches, allowing focal inflammation and firm attachment of the fornical conjunctiva to the globe. The mean follow-up period (±SD) was 234.4 ± 179.9 days (range, 55- 536 days).
The tear meniscus was maintained normal in all eyes (n=23). No recurrence of conjunctivochalasis was observed during the follow-up period.
Our operative method was successful and there were no recurrences during follow-up.
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