Changes of conjunctivochalasis with age in a hospital-based study.

PURPOSE: To assess the relationship between age and the incidence and severity of conjunctivochalasis by using the grading system for conjunctivochalasis proposed by Meller and Tseng. DESIGN: Prospective, nonrandomized, consecutive case study. METHODS: A total of 1,416 patients aged one to 94 years were enrolled. The age, gender, medical history, ocular history, and grade and parameters of conjunctivochalasis at three locations (nasal, middle, and temporal) were determined in all subject. RESULTS: The prevalence of conjunctivochalasis increased dramatically with age (one to 10 years, 6.8%; 11 to 20 years, 36.2%; 21 to 30 years, 61.5%; 31 to 40 years, 71.4%; 41 to 50 years, 90.2%; 51 to 60 years, 94.2%; 61 to 70 years, 98.0%; 71 to 80 years, 99.0%; 81 to 90 years, 98.5%; and 91 to 100 years, 100.0%). The mean grade of conjunctivochalasis was higher in female patients than in male patients (nasal area, P = .0229; temporal area, P = .0078) and was higher for the temporal conjunctiva than the nasal conjunctiva (P < .0000001). Parameters such as the downward gaze- or digital pressure-dependent changes of conjunctivochalasis and the presence of superficial punctate keratitis all increased with age. These conjunctivochalasis-related parameters were correlated with the severity of conjunctivochalasis (P < .00001), especially of the middle bulbar conjunctiva. CONCLUSIONS: We report the grade of conjunctivochalasis in a large series of consecutive patients. Our results strongly suggest that conjunctivochalasis is an age-dependent eye disease that occurs in young adulthood and thereafter. The present grading system should be useful for future clinical studies of conjunctivochalasis.

Intracameral air injection for acute hydrops in keratoconus.

PURPOSE: To evaluate the efficacy and safety of intracameral air injection in treating acute hydrops in keratoconus. DESIGN: Retrospective, nonrandomized, comparative trial. PATIENTS: Thirty eyes (30 patients) with acute hydrops secondary to keratoconus. INTERVENTION: Nine eyes (nine patients) with acute hydrops in keratoconus were treated with intracameral injection of 0.1 ml filtered air. Additional 0.1 ml filtered air was injected if corneal edema persisted when air disappeared from the anterior chamber. Twenty-one eyes (21 patients) with acute hydrops that received no therapy or conventional therapy not likely to shorten the duration of hydrops served as controls. MAIN OUTCOME MEASURES: The period of persistence of corneal edema, the interval between the onset of acute hydrops, and the time when the eye could begin to wear a hard-contact lens, and best spectacle-corrected and hard-contact lens-corrected visual acuity after corneal edema subsided were used as criteria to evaluate any differences between the two groups. RESULTS: The average period of persistence of corneal edema was 20.1 +/- 9.0 days (+/- SD) in the intracameral air injection group and 64.7 +/- 34.6 days in the control (P =.0008). The average interval between the onset of acute hydrops and the time when the eye could begin to wear a hard-contact lens, was 33.4 +/- 5.6 days in the air injection group and 128.9 +/- 85.8 days in the control group (P =.0058). The best-corrected visual acuity after corneal edema subsided was similar between the two groups. Intracameral air injection induced no complications. CONCLUSIONS: The results suggest that the intracameral air injection is a safe and useful therapy to shorten the period of corneal edema in acute hydrops secondary to keratoconus.