title: Clinicopathologic study of conjunctivochalasis.
abstract: OBJECTIVE
  To clarify the structural features of conjunctivochalasis histopathologically.
  
  
  METHODS
  A biopsy of redundant conjunctiva from the same anatomic location of 44 +/- 7.5 years (mean +/- SD, 50.87 years), underwent conjunctivoplasty (termed tear meniscus reconstruction).
  
  
  RESULTS
  In all 44 cases, histologic examination disclosed normal conjunctival epithelium and negligible inflammation and lymphocyte infiltration; 39 patients manifested microscopic lymphangiectasia. Elastica van Gieson staining demonstrated elastic fiber fragmentation and sparsely assembled collagen fibers in all 44 cases. There was no discernible difference between specimens from patients with and without complications including tear-deficient dry eye, meibomian gland dysfunction, and clinically observable lymphangiectasia and/or pinguecula.
  
  
  CONCLUSIONS
  Based on our histopathologic findings, we hypothesize that mechanical forces between the lower lid and conjunctiva gradually interfered with lymphatic flow. Chronic, prolonged mechanical obstruction of lymphatic flow may result in lymphatic dilation and eventually give rise to clinical conjunctivochalasis.
authors.affiliation: Department of Ophthalmology, Kyoto Prefectural University of Medicine, Kyoto, Japan.
authors.forename: Akihide
authors.initials: A
authors.lastname: Watanabe
authors.forename: Norihiko
authors.initials: N
authors.lastname: Yokoi
authors.forename: Shigeru
authors.initials: S
authors.lastname: Kinoshita
authors.forename: Yoko
authors.initials: Y
authors.lastname: Hino
authors.forename: Yasunari
authors.initials: Y
authors.lastname: Tsuchihashi
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D003229:Conjunctival Diseases / Q000150:complications / Q000473:pathology*; D005141:Eyelid Diseases / Q000473:pathology; D005260:Female; D006801:Humans; D007766:Lacrimal Apparatus Diseases / Q000209:etiology / Q000473:pathology; D008200:Lymphangiectasis / Q000150:complications / Q000473:pathology*; D008297:Male; D008875:Middle Aged