title: Clinical evaluation of the quantitative locator for conjunctiva resection used as an instrument for the treatment of conjunctivochalasis.
abstract: BACKGROUND
  The crescent excision of the inferior bulbar conjunctiva has been advised as a surgical procedure in the management of conjunctivochalasis refractory to medical treatments. However, it is difficult for this procedure to design how much conjunctival tissue should be excised. This study aimed to present a quantitative locator for conjunctiva resection and evaluate its effect on the treatment of conjunctivochalasis (CCh).
  
  
  METHODS
  Poly β-hydroxyethyl methacrylate resin/β-hydroxyethyl methacrylate (HEMA, water gel) was used as the material to make the quantitative locator which was designed to suit the specific patient. Forty-six patients with bilateral symptomatic CCh were included in this prospective study. Of the patients, while the right eye underwent the popularly used crescent-shaped conjunctiva resection (group I), the left eye was treated with conjunctiva resection assisted by the quantitative locator (group II). International Ocular Surface Disease Index (OSDI), scores of remnant conjunctiva fold, complications and conjunctival cut healing, height of tear meniscus, tear break-up time (BUT), and time of surgery were evaluated. Tasting chloromycetin test (TCT) was used to evaluate how the lacrimal duct worked.
  
  
  RESULTS
  OSDI in group II (8.82 ± 2.36) was significantly lower than that in group I (14.67 ± 2.21) (t = 12.22, P < 0.01). The amount of conjunctiva fold remaining in group II was less than that in group I. Scores of remnant conjunctiva fold in group I were significantly higher than those in group II (t = 31.85, P < 0.01). While evaluation scores of conjunctival cut healing in group I were lower than those in group II, scores of complication in group I were significantly higher than those in group II at 8 weeks after surgery (t = 89.60, P < 0.01). There was no significant difference in eyes with normal BUT (χ(2) = 0.031, P = 0.985) between the two groups, as the case was in eyes with positive TCT (χ(2) = 0.14, P = 0.930) and in eyes with normal height of tear meniscus (χ(2) = 0.48, P = 0.780). Mean surgery time in group II ((17.11 ± 2.08) minutes) was significantly shorter than that in group I ((25.22 ± 4.78) minutes) (t = 13.84, P < 0.01).
  
  
  CONCLUSIONS
  A quantitative locator can be used as an effective, safe, and less time-consuming instrument to facilitate conjunctival excision for symptomatic CCh treatment.
authors.affiliation: Department of Ophthalmology, Putuo Hospital, Shanghai Chinese Traditional Medicine University, Shanghai 200062, China.
authors.forename: Qing-song
authors.initials: QS
authors.lastname: Li
authors.forename: Xing-ru
authors.initials: XR
authors.lastname: Zhang
authors.forename: Min-hong
authors.initials: MH
authors.lastname: Xiang
authors.forename: Yi-ren
authors.initials: YR
authors.lastname: Zheng
authors.forename: Huan-ming
authors.initials: HM
authors.lastname: Zhou
authors.forename: Zhen-yong
authors.initials: ZY
authors.lastname: Zhang
authors.forename: Long
authors.initials: L
authors.lastname: Zhang
mesh_terms: D000368:Aged; D003228:Conjunctiva / Q000601:surgery*; D003229:Conjunctival Diseases / Q000601:surgery*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D013508:Ophthalmologic Surgical Procedures / Q000009:adverse effects / Q000379:methods; D011446:Prospective Studies; D016896:Treatment Outcome