Changes of conjunctivochalasis after cataract surgery via a superior transconjunctival sclerocorneal incision

• Published in: International ophthalmology 2017-06, Vol.37 (3), p.691-700
• Main Authors: Mimura, Tatsuya, Iida, Michiko, Oshima, Rie, Noma, Hidetaka, Kamei, Yuko, Goto, Mari, Kondo, Aki, Matsubara, Masao
• Format: Article
• Language: English
• Subjects: Aged; Aged, 80 and over; Axial Length, Eye - pathology; Cataract Extraction - adverse effects; Cataracts; Conjunctiva - surgery; Conjunctival Diseases - etiology; Conjunctival Diseases - pathology; Disease Progression; Evaluation; Eye (anatomy); Eye lens; Eye surgery; Female; Follow-Up Studies; Grading; Humans; Implantation; Intraocular lenses; Male; Medicine; Medicine & Public Health; Middle Aged; Ophthalmology; Original Paper; Postoperative Complications; Prospective Studies; Quality; Refraction; Regression analysis; Risk Factors; Sclera - surgery; Severity of Illness Index; Surgery
• ISSN: 0165-5701; 1573-2630
• DOI: 10.1007/s10792-016-0328-y

The purpose of this study was to evaluate the changes in the severity of conjunctivochalasis after cataract surgery performed via a superior conjunctival sclerocorneal incision. Prospective investigation was performed in a consecutive series of 36 eyes of 36 patients aged 62–85 years who underwent phacoemulsification and implantation of a 6.0-mm foldable intraocular lens through a 2.8-mm superior sclerocorneal incision. The age, gender, medical history, ocular history, grade, refraction, and axial length were determined in all subjects. The conjunctivochalasis score (0–3) and other parameters were determined at three sites (nasal, middle, and temporal) according to the system for grading conjunctivochalasis proposed by Meller and Tseng (at baseline and at 1, 4, and 12 weeks postoperatively). The total conjunctivochalasis score (sum of the scores for the temporal, middle, and nasal regions: 0–9) increased significantly from 4.0 ± 1.9 at baseline to 4.8 ± 2.1 at 1 week postoperatively ( p  = 0.0048), and subsequently decreased again at 4 weeks (4.3 ± 2.0) and 12 weeks (4.0 ± 1.9). Multivariate logistic regression analysis showed that progression of conjunctivochalasis at 12 weeks was significantly associated with the axial length [odds ratio (OR) = 1.21, p  = 0.0118] and with conjunctival suture placement (OR = 1.34, p  = 0.0493). When cataract surgery was performed via a superior sclerocorneal incision, the severity of conjunctivochalasis at 12 weeks postoperatively was similar to that at baseline. Our findings suggest that a superior sclerocorneal incision has no influence on the progression of conjunctivochalasis after cataract surgery.