Original articlesNew surgical treatment for superior limbic keratoconjunctivitis and its association with conjunctivochalasis☆
Section snippets
Methods
Six eyes of five patients (four from three female patients and two from two male patients) ranging in age from 35 to 61 years (51.8 ± 11.0 years [mean ± SD]) were treated using our new surgical technique. All patients had a long history of severe irritative ocular symptoms that were largely unresponsive to treatment with eye drops mixed with preservative-free artificial tears containing 0.1% KCl and 0.4% NaCl (Softsantear; Santen Pharmaceutical, Osaka, Japan), or 0.1% fluoromethorone
Results
As shown in Table 1, hyperthyroidism was present in Case 2, a 55-year-old woman who underwent surgery to both eyes owing to the severity of her symptoms. In her right eye we noted a corneal filament in addition to SPK; her left eye manifested SPK. In Case 1, a 61-year-old woman, the Schirmer I test and fluorescein staining detected tear-deficient dry eye; SPK was also present, and the nasal and temporal portion of the bulbar conjunctiva was stained with RB. All operated-on eyes were moderately
Discussion
Our RB staining data demonstrate that the surgical procedure we developed resulted in the complete resolution of abnormal limbal and conjunctival lesions by 2 weeks after the operation; conjunctival hyperemia associated with SLK was also resolved by 1 month. Our procedure does not target the RB-stained limbal and conjunctival lesion, but rather the superior conjunctival portion distal to the lesion, a site at which histological inspection confirmed the existence of normal conjunctival
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2022, Survey of OphthalmologyCitation Excerpt :Repeat impression cytology at 3 months following surgery showed improvement of the nuclear/cytoplasmic ratio and reappearance of goblet cells.88 They suggested that this technique was efficacious because the pathogenesis of SLK involves the redundant conjunctiva extending superiorly from the rose bengal stained area to the healthy bulbar conjunctiva.88 Sun and colleagues explored the use of superior bulbar conjunctival resection combined with Tenon capsule excision in 40 patients.
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This study was supported in part by a research grant from the Kyoto Foundation for the Promotion of Medical Science and the Intramural Research Fund of the Kyoto Prefectural University of Medicine.