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Suh and Choi: The Effect of Conjunctivochalasis Surgery Using a High-Frequency Radio-Wave Electrosurgical Unit
Original Article
Journal of the Korean Ophthalmological Society

Journal of the Korean Ophthalmological Society 2012; 53(11): 1571-1576.

Published online: 16 November 2012

DOI: https://doi.org/10.3341/jkos.2012.53.11.1571

The Effect of Conjunctivochalasis Surgery Using a High-Frequency Radio-Wave Electrosurgical Unit

Jae Shin Suh, MD, Sangkyung Choi, MD, PhD

Department of Ophthalmology, Seoul Veterans Hospital, Seoul, Korea.

Address reprint requests to Sangkyung Choi MD, PhD. Department of Ophthalmology, Seoul Veterans Hospital, #53 Jinhwangdo-ro 61-gil, Gangdong-gu, Seoul 134-791, Korea. Tel: 82-2-2225-1382, Fax: 82-2-2225-1485, drskchoi@hanmail.net

Received 26 March 2012       Accepted 16 October 2012

Copyright © 2012 The Korean Ophthalmological Society

Abstract

Purpose

To evaluate the effects of conjunctivochalasis surgery using a high-frequency radio-wave electrosurgical unit.

Methods

Twenty-seven eyes of 14 patients with conjuctivochalasis who received surgeries with shrinkage of the inferior bulbar conjunctiva using a high-frequency radio-wave electrosurgical unit (Ellman surgitron®) were evaluated. Conjuctivochalasis grade, the ocular symptoms, Ocular Surface Disease Index (OSDI), tear film break-up time (BUT), Schirmer test, and corneal staining with fluorescein were measured preoperatively, at 3 months postoperatively, and analyzed prospectively.

Results

Three months after the surgery, all patients' conjunctivochalasis became grade 0, and the ocular symptoms, OSDI score, BUT, and corneal staining with fluorerscein were also improved. Additionally, there were no specific complications during the follow-up period.

Conclusions

Conjunctivochalasis surgery using a high-frequency radio-wave electrosurgical unit produced an effective improvement in conjuctivochalasis grade and symptoms and appeared to be a simple and safe procedure.

Keywords: Conjunctivochalasis, High-frequency radio-wave electrosurgical unit

Figures and Tables

Figure 1
Conjunctivochalasis surgery using high frequency radio wave electrosurgical unit. (A) The redundant inferior bulbar conjunctiva was grabbed and estimated with smooth forcep. (B) A fine-needle electrode was located within subconjunctiva in a horizontal direction. (C) Subconjunctival coagulation was made (arrow). (D) On average, 6 to 8 subconjunctival coagulations were made.
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Figure 2
Schematic presentation of conjunctivochalasis surgery (e.g. right eye). Six points were designated for subconjunctival coagulation (gray spot).
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Figure 3
A representative case of conjunctivochalasis surgery. (A, B) A 81-year-old man. Preoperative appearance. (C, D) One week after surgery. (E, F) One month after surgery.
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Table 1
Grading of conjunctivochalasis
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Table 2
Grading of corneal staining: Oxford Scheme
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Table 3
Changes of conjunctivochalasis grade at 3 months (n = 27)
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Values are presented as number (%).

Table 4
Comparison between preoperative and postoperative clinical features at 3 months after surgery
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Values are presented as mean ± SD.

OSDI = ocular surface disease index, BUT = tear film break-up time.

References

1. Meller D, Tseng SC. Conjunctivochalasis: literature review and possible pathophysiology. Surv Ophthalmol. 1998. 43:225–232.
2. Di Pascuale MA, Espana EM, Kawakita T, Tseng SC. Clinical characteristics of conjunctivochalasis with or without aqueous tear deficiency. Br J Ophthalmol. 2004. 88:388–392.
3. Jordan DR, Pelletier CR. Conjunctivochalasis. Can J Ophthalmol. 1996. 31:192–193.
4. Huges WL. Conjunctivochalasis. Am J Ophthalmol. 1942. 25:48–51.
5. Meller D, Maskin SL, Pires RT, Tseng SC. Amniotic membrane transplantation for symptomatic conjunctivochalasis refractory to medical treatments. Cornea. 2000. 19:796–803.
6. Georgiadis NS, Terzidou CD. Epiphora caused by conjunctivochalasis: treatment with transplantation of preserved human amniotic membrane. Cornea. 2001. 20:619–621.
7. Kheirkhah A, Casas V, Blanco G, et al. Amniotic membrane transplantation with fibrin glue for conjunctivochalasis. Am J Ophthalmol. 2007. 144:311–313.
8. Lim HJ, Lee JK, Park DJ. Conjunctivochalasis surgery: amniotic membrane transplantation with fibrin glue. J Korean Ophthalmol Soc. 2008. 49:195–204.
9. Nam K, Jo YJ, Lee SB. The efficacy of fibrin glue in surgical treatment of conjunctivochalasis with epiphora. J Korean Ophthalmol Soc. 2010. 51:498–503.
10. Oh SJ, Byon DS. Treatment of conjunctivochalasis using bipolar cautery. J Korean Ophthalmol Soc. 1999. 40:707–711.
11. Otaka I, Kyu N. A new surgical technique for management of conjunctivochalasis. Am J Ophthalmol. 2000. 129:385–387.
12. Youm DJ, Kim JM, Choi CY. Simple surgical approach with high-frequency radio-wave electrosurgery for conjunctivochalasis. Ophthalmology. 2010. 117:2129–2133.
13. Walt J. Ocular Surface Disease Index (OSDI) Administration and Scoring Manual. 2004. Irvine, CA: Allergan, Inc..
14. Bron AJ, Evans VE, Smith JA. Grading of corneal and conjunctival staining in the context of other dry eye tests. Cornea. 2003. 22:640–650.
15. Francis IC, Chan DG, Kim P, et al. Case-controlled clinical and histopathological study of conjunctivochalasis. Br J Ophthalmol. 2005. 89:302–305.
16. Watanabe A, Yokoi N, Kinoshita S, et al. Clinicopathologic study of conjunctivochalasis. Cornea. 2004. 23:294–298.
17. Meller D, Li DQ, Tseng SC. Regulation of collagenase, stromelysin, and gelatinase B in human conjunctival and conjunctivochalasis fibroblasts by interleukin-1 beta and tumor necrosis factor-alpha. Invest Ophthalmol Vis Sci. 2000. 41:2922–2929.
18. Ko SM, Kim MK, Kim JC. The role of mast cell in hyperlaxity of conjunctiva. J Korean Ophthalmol Soc. 1997. 38:949–955.
19. Udell IJ, Kenyon KR, Sawa M, Dohlman CH. Treatment of superior limbic keratoconjunctivitis by thermocauterization of the superior bulbar conjunctiva. Ophthalmology. 1986. 93:162–166.
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