Retro Conjunctival Radiofrequency Electrocautery With A Fine Needle For Conjunctivochalasis-A Novel Surgical Technique.

Conjunctivochalasis is associated with disruption of the tear meniscus, delayed tear clearance, and punctal occlusion. Different surgical procedures have been described to reduce CCh, such as simple excision, excision, and amniotic membrane transplantation (AMT) with suture or fibrin glue, fixation of the conjunctiva to the sclera, or superficial cauterization with a bipolar electrical cauterizer. However, these surgical procedures introduce certain disadvantages, including prolonged operating time, postoperative discomfort, and suture-related complications. we describe a novel technique using fine needle RF cautery, which coagulates redundant conjunctiva thus reversing the symptoms.

On the inferior bulbar conjunctiva, retroconjunctival coagulation was performed with a fine needle electrode using a high-frequency radiofrequency cautery unit in coagulation mode under low coagulation settings. 

16 patients (28 eyes) were included in the study, patients were followed up for 6 months after surgery and evaluated clinically and symptomatically (OSDI Score).

28 eyes recovered a smooth, wet, and noninflamed conjunctival surface within 1 month and remained stable for a follow-up period of 6 months. At 6 months postoperatively, 28 eyes  had grade 0 CCh with a statistically significant decrease in the OSDI score at 6 months postoperatively.

This new technique of retro-conjunctival RF cautery proves to be simple and effective in the reversal of conjunctival contour and establishing tear stability thus reducing patients' symptoms.