Ocular surface improvement after conjunctivochalasis (CCH) surgery

Purpose To evaluate symptomatology and ocular surface changes in patients with CCH grade III after excision surgery. Methods Prospective, interventional study in which 15 patients with CCH grade III were enrolled. Patients underwent CCH excision surgery: 8 patients underwent semiperitomy perilimbic with cauterization technique and 7 paste-pinch-cut conjunctivoplasty. The following ocular surface properties were studied preoperatory and 6 weeks after surgical intervention: – Symptoms by using Ocular Surface Disease Index questionnaires (OSDI) – Tear Osmolarity by using Tearlab Osmolarity System®. – Tear Break Up Time (BUT) – Tear clearance and Tear Function Index by using fluorescein test measure by schirmer strip stain. (Vico and Benitez del Castillo technique) – Corneal and conjunctival stain:Lissamin green (0–3 grades) and Fluorescein: (0–3 grades) Results OSDI questionnaire confirm symptomatology improvement after surgery. Fluorescein Test measure by Schirmer strip stain reveal a better tear clearance. Fluorescein corneal stain and lissamine green corneal stain decrease. Osmolarity ocular surface values and tear BUT normalise after surgery. There was not significant difference between semiperitomy perilimbic with cauterization technique and paste-pinch-cut conjunctivoplasty. Conclusions CCH patients have an increase proteolytic activitiy in ocular surface. Conjunctival excess interfere with appropriate meniscus tear formation and translate to a deficient corneal tear film. Inflammation control and conjunctival mechanical restore by surgery decrease ocular surface symptomps, improve tear clearance and tear stability and normalize osmolarity values.