Cheng Anny M S, Mead Olivia G, Tighe Sean, Tseng Scheffer C G
Department of Ophthalmology, Broward Health, Fort Lauderdale, Florida, USA.
Department of Ophthalmology, Florida International University, Herbert Wertheim College of Medicine, Miami, Florida, USA.
Taiwan J Ophthalmol. 2022 Jul 15;13(1):49-54. doi: 10.4103/tjo.tjo_28_22. eCollection 2023 Jan-Mar.
To assess the extent of inferior fornix shortening in conjunctivochalasis (CCh) and to evaluate whether fornix deepening reconstruction can restore the fornix tear reservoir in patients with CCh.
This was a retrospective review of five patients (3 unilateral and 2 bilateral eyes, total 7 eyes) with CCh who underwent fornix deepening reconstruction with conjunctival recession and amniotic membrane transplantation. Postsurgical outcome measures included changes in fornix depth with correlation to basal tear volumes, symptoms, corneal staining, and conjunctival inflammation.
For the three patients with unilateral surgery, both the fornix depth (8.3 ± 1.5 mm) and wetting length (9.3 ± 8.5 mm) of the operative eyes were less than the fellow eyes (10.3 ± 1.5 mm and 10.3 ± 8.5 mm, respectively). At 5.3 ± 2.7 months (range 1.7-8.7) postoperatively, the fornix depth increased significantly by 2.0 ± 1.1 mm ( = 0.02). Deepening of the fornix depth was accompanied by overwhelming symptomatic relief (91.5%) that could be subdivided into complete relief (87.5%) and partial relief (4%) of symptoms, with blurred vision being the most notably relieved symptom ( = 0.03). Furthermore, superficial punctate keratitis and conjunctival inflammation were significantly improved at follow-up ( = 0.008 and 0.05, respectively).
Deepening of the fornix to restore the tear reservoir is an important surgical objective that may change the tear hydrodynamic state to provide a stable tear film and improve outcomes in CCh.
评估结膜松弛症（CCh）患者下穹窿缩短的程度，并评估穹窿加深重建能否恢复CCh患者的穹窿泪液储存功能。
这是一项对5例CCh患者（3例单眼，2例双眼，共7只眼）进行回顾性研究，这些患者接受了结膜退缩联合羊膜移植的穹窿加深重建术。术后观察指标包括穹窿深度变化及其与基础泪液量、症状、角膜染色和结膜炎症的相关性。
对于3例接受单眼手术的患者，术眼的穹窿深度（8.3±1.5mm）和湿润长度（9.3±8.5mm）均小于对侧眼（分别为10.3±1.5mm和10.3±8.5mm）。术后5.3±2.7个月（范围1.7 - 8.7个月），穹窿深度显著增加2.0±1.1mm（P = 0.02）。穹窿深度加深伴随着症状的显著缓解（91.5%），可细分为症状完全缓解（87.5%）和部分缓解（4%），其中视力模糊是最明显缓解的症状（P = 0.03）。此外，随访时浅层点状角膜炎和结膜炎症均有显著改善（分别为P = 0.008和P = 0.05）。
加深穹窿以恢复泪液储存功能是一项重要的手术目标，这可能改变泪液流体动力学状态，从而提供稳定的泪膜并改善CCh的治疗效果。
