Modified Simple Excision for Epicanthal Folds

PURPOSE: To evaluate the effect of modified simple excision for epicanthal folds. METHODS: Eight patients with the epicanthal folds were treated using a modified simple excision method from June to December 2005. After medial traction of the epicanthal fold to expose the medial canthus, parabola-shaped marking was done near mucocutaneous junction. Under local anesthesia, incision of skin, dissection of subcutaneous tissue and excision of subcutaneous fibrous tissue and orbicularis oculi muscle were done. After marking the medial canthus on the skin, a wedge-shaped excision of the extra skin was done. Fixation sutures to the medial canthal tendon and skin sutures were then performed. RESULTS: Eight participants were evaluated (four males and four females) with a mean age of 16.71+/-8.34 years. The mean follow-up period was 42.86+/-5.80 days. After the operation, the skin scar was not visible due to its deep position, and no complication, such as damage to the lacrimal canaliculus or sac, was observed. CONCLUSIONS: Modified simple excision for epicanthal folds is an effective method that does not leave a visible scar.

Effects of Cauterization with Suturing in Treatment of Conjunctivochalasis: 4 Cases

PURPOSE: We performed cauterization and suturing without resection and evaluated the technique's efficacy in the treatment of conjunctivochalasis. METHODS: Four eyes of three patients diagnosed with conjunctivochalasis were treated with cauterization and suturing. After opening the eyelids, the loosened bulbar conjunctiva was pulled down tensely. After local anesthesia near the inferior fornix (about 8 mm below the limbus), the bulbar conjunctiva and Tenon's capsule were gripped together by bipolar cautery (UM 150A). The cauterization was performed in one second. Still gripped by the bipolar cautery, the bulbar conjunctiva and Tenon's capsule were fixed to the sclera with Vicryl 6-0. Identical procedures were performed on two other sites along the inferior fornix. The suture stitch were removed 10 days after the surgical procedure. RESULTS The objects were 4 eyes of 3 patients (1 male, 2 females with an average age of 63 years). The mean follow-up period was 4 months. There were no recurrences or any postoperative complications caused by cauterization. CONCLUSIONS: We successfully treated conjunctivochalasis with a simple procedure of conjunctival fixation to the sclera through cauterization and suturing.

Effects of Cauterization with Suturing in Treatment of Conjunctivochalasis: 4 Cases

PURPOSE: We performed cauterization and suturing without resection and evaluated the technique's efficacy in the treatment of conjunctivochalasis. METHODS: Four eyes of three patients diagnosed with conjunctivochalasis were treated with cauterization and suturing. After opening the eyelids, the loosened bulbar conjunctiva was pulled down tensely. After local anesthesia near the inferior fornix (about 8 mm below the limbus), the bulbar conjunctiva and Tenon's capsule were gripped together by bipolar cautery (UM 150A). The cauterization was performed in one second. Still gripped by the bipolar cautery, the bulbar conjunctiva and Tenon's capsule were fixed to the sclera with Vicryl 6-0. Identical procedures were performed on two other sites along the inferior fornix. The suture stitch were removed 10 days after the surgical procedure. RESULTS The objects were 4 eyes of 3 patients (1 male, 2 females with an average age of 63 years). The mean follow-up period was 4 months. There were no recurrences or any postoperative complications caused by cauterization. CONCLUSIONS: We successfully treated conjunctivochalasis with a simple procedure of conjunctival fixation to the sclera through cauterization and suturing.

Management of Prolapsed Silicone Tube Inserted for Treatment of Nasolacrimal Duct Obstruction

PURPOSE: To introduce a new surgical management for the prolapsed silicone tube into the ocular surface which was inserted for treatment of nasolacrimal duct obstruction. METHODS: Five eyes of 179 eyes treated with silicone tube intubation for nasolacrimal duct obstruction from May to December 2003 had a prolapsed silicone tube during the follow-up period. After local anesthesia, a Ritleng probe was inserted into the nasolacrimal duct. A polypropylene thread was passed into the Ritleng probe, and after removal of the probe, the thread was tied to a prolapsed silicone tube near a punctum and was pulled through the nose. The silicone tube was repositioned in the nasolacrimal duct. RESULTS: All the prolapsed silicone tubes were successfully repositioned without any significant complications. CONCLUSIONS: It is difficult to reposition a prolapsed silicone tube after silicone tube intubation for the treatment of nasolacrimal duct obstruction. We introduced an easy and effective method to reposition the prolapsed silicone tube.