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Oh, Park, Yim, and Lee: Treatment of Epiphora in Patients with Conjunctivochalasis Using Conjunctival Fixation to the Sclera
Original Article
Journal of the Korean Ophthalmological Society

Journal of the Korean Ophthalmological Society 2012; 53(8): 1063-1067.

Published online: 17 August 2012

DOI: https://doi.org/10.3341/jkos.2012.53.8.1063

Treatment of Epiphora in Patients with Conjunctivochalasis Using Conjunctival Fixation to the Sclera

Seung Hoon Oh, MD, Jae Young Park, MD, Hye Bin Yim, MD, PhD, Na Young Lee, MD, PhD

Department of Ophthalmology, Incheon St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Incheon, Korea.

Address reprint requests to Na Young Lee, MD, PhD. Department of Ophthalmology, Incheon St. Mary's Hospital, #56 Dongsu-ro, Bupyeong-gu, Incheon 403-720, Korea. Tel: 82-32-280-5110, Fax: 82-32-280-5833, Ny55@freechal.com

Received 14 September 2011       Accepted 12 May 2012

Copyright © 2012 The Korean Ophthalmological Society

Abstract

Purpose

To report the effects and complications of conjunctival fixation to the sclera in conjunctivochalasis patients with inferior punctal occlusion.

Methods

The authors of the present study evaluated the degree of conjunctivochalasis and performed Fluorescein Dye Disappearance Test (FDT) in 15 eyes of 8 patients diagnosed with conjunctivochalasis with inferior punctal occlusion. Under topical anesthesia, the inferior bulbar conjunctiva was attached to the sclera with 3 8-0 vicryl stitches 8 mm posterior from the limbus. After surgery, the relief of symptoms, postoperative complications and improvement of conjunctivochalasis were observed.

Results

One week after the surgery, all 15 eyes achieved a subjective improvement of symptoms and the degree of conjunctivochalasis and FDT showed statistical difference after surgery (p = 0.000, 0.000, respectively). A complication occurred in 1 eye which was a retinal hemorrhage due to scleral puncture.

Conclusions

Conjunctival fixation to the sclera could improve epiphora in conjunctivochalasis patients with inferior punctal occlusion. However, this procedure should be performed with caution.

Keywords: Conjunctivochalasis, Epiphora, Scleral fixation suture

Figures and Tables

Figure 1
(A) Intraoperative photograph of the surgical procedure. To expose the inferior fornix, we placed a corneal traction suture with 8-0 Vicryl. (B) Postoperative photograph. Central suture material was observed about 8mm from the limbus (arrow).
jkos-53-1063-g001
Figure 2
(A) A 74-year-old man with conjunctivochalasis of grade 2. Conjunctival folds on the central and medial lower eyelid margin were observed. (B) Redundant conjunctiva was seen definitely with fluorescein dye. (C) Seven months after surgery, no conjunctival folds were evident on the lower eyelid margin.
jkos-53-1063-g002
Figure 3
Graphs demonstrating the degree of conjunctivochalasis and fluorescein dye disappearance test preoperatively and postoperatively. Each dot represents the average of each factor (95% confidence interval). *Statistical significance (p < 0.05) compared with preoperative status.
jkos-53-1063-g003

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