Treatment of Conjunctivochalasis Using Bipolar Cautery

ABSTRACT

Conjunctivochalasis cause epiphora because abnormal redundant conjunctival tissue obstruct the punctum and block the tear outflow. The surgical resection of the redundant conjunctial tussue with scissors has been performed but it has caused such problems as difficult control of bleeding, long surgical time, high incidence of subconjunctival hemorrhage and cosmetic dissatisfaction. Therefore, the authors performed the operation of conjunctivochalasis with bipolar cautery instead of scissors and evalunted the efficacy of this new method. The authors prospectively studied 9 patients(16 eyes) of conjunctivochalasis who complained of epiphora and were found to have redundancy of conjunctival tissue around the punctal area on slit-lamp examination. They have neither lacrimal pathway insufficiency and obstruction, nor facial falsy or lid laxity that impair the lacrimal pump action, and also no anatomical anomaly of the punta was noted. After marking of redundant conjunctival tissue with gentian Violet under the operationg microscope and topiacal anethesia wint 4% lidocaine, redundant conjunctival tissue was removed by bipolar cautery. We also cauterized exposed Tenon`s capsule to contract the wound. Suture was not performed or three interrupted suture were placed. Epiphora was improved after simple cauterization of redundant conjunctiva in 15 eyes out of 16 eyes during at least 2 months of follow-up period. Removal of redundant lower incidence of subconjunctival hemorrhage than resection technique using scissore. We expect that this surgical technique will substitute for established technique with scissors beause bipolar cautery method was simple and showed lower incidence of complications.