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Medial Conjunctival Resection for Tearing Associated With Conjunctivochalasis

Petris, Carisa K. M.D., PH.D.; Holds, John B. M.D., F.A.C.S.

Ophthalmic Plastic and Reconstructive Surgery: July/August 2013 - Volume 29 - Issue 4 - p 304–307
doi: 10.1097/IOP.0b013e3182831dd3
Original Investigation
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Purpose: Conjunctivochalasis is an age-dependent redundancy or laxity of the conjunctiva. It may result in epiphora (tearing) through mechanical disruption of the normal tear flow or exacerbate dry eye symptoms by disruption of an already unstable tear film. In this study, the authors performed a retrospective analysis of the benefits of a simple medial conjunctival resection for tearing associated with conjunctivochalasis.

Methods: A review of medical records identified 18 patients (25 eyes) who underwent a medial conjunctivoplasty for tearing between 2000 and 2012. The degree of epiphora was graded for each patient from 0 (no tearing) to 3 (persistent tearing requiring surgical correction). All patients were given an initial preoperative score of 3. Patients were excluded from the study if more than 1 eyelid procedure that would affect the lacrimal pump function was performed at the time of conjunctivoplasty or if clinically significant entropion, ectropion, or nasolacrimal duct obstruction was present at the time of conjunctivoplasty.

Results: At an average of 2.7 months post-conjunctivoplasty (range 4 weeks to 12 months), 80% of patients improved to a score of 2 or better and 60% improved to 1 or better. Six patients ultimately needed an additional surgical procedure for unresolved or recurrent tearing.

Conclusions: The data suggest that conjunctivoplasty using a simple medial conjunctival resection is an effective treatment for patients with epiphora secondary to conjunctivochalasis.

Patients with tearing related to conjunctivochalasis were found to improve following a simple, medial bulbar conjunctival excision.

*Department of Ophthalmology, University of Missouri, Columbia, Departments of Ophthalmology and Otolaryngology-Head and Neck Surgery, St. Louis University, St. Louis, and Ophthalmic Plastic and Cosmetic, Inc., St. Louis, Missouri, U.S.A.

Accepted for publication October 14, 2012.

This study was reviewed and approved by the Institutional Review Board of University of Missouri, Columbia, MO.

This study was funded, in part, by a departmental grant from the Department of Ophthalmology, University of Missouri, Missouri, U.S.A.

The authors have no conflicts of interest to disclose.

Address correspondence and reprint requests to Carisa K. Petris, M.D., Ph.D., Mason Eye Institute, 1 Hospital Dr., Columbia, MO 65212. E-mail: Petrisc@health.missouri.edu

© 2013 by The American Society of Ophthalmic Plastic and Reconstructive Surgery, Inc., All rights reserved.