Treatment of Conjunctivochalasis Using Bipolar Cautery.

Oh, Se Jin; Byon, Doseok

Original Article

Journal of the Korean Ophthalmological Society 1999;40(3):707-711.
Published online March 1, 1999.

Treatment of Conjunctivochalasis Using Bipolar Cautery.

Se Jin Oh, Doseok Byon

Department of Ophthalmology, College of Medicine, Inha University.

양극성 전기소작기를 이용한 결막이완증의 치료

오세진(Se Jin Oh),변도석(Do Seok Byon)

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.

Key Words: Bipolar cautery;conjunctivochalasis;Epiphora;Subconjunctival hemorrhage