title: Paste-pinch-cut conjunctivoplasty:  subconjunctival fibrin sealant injection in the repair of conjunctivochalasis.
abstract: OBJECTIVE
  To describe a new surgical technique for the repair of conjunctivochalasis (CCh) using subconjunctival injection of fibrin sealant followed by conjunctival resection and to present a case series demonstrating our experience with the paste-pinch-cut technique.
  
  
  METHODS
  A total of 139 eyes of 70 patients (43 women, 27 men) with CCh unresponsive to medical therapy received the described surgical treatment. The procedure consists of 3 primary steps-paste: fibrin sealant is injected subconjunctivally in a line inferior to the limbus; pinch: the conjunctiva is grasped with curved ptosis forceps, gathering the excess conjunctiva into a ridge, which is held, allowing the sealant to polymerize; and cut: the ridge of excess conjunctiva and sealant is resected. Subjective symptoms were assessed after surgery.
  
  
  RESULTS
  Conjunctival redundancy was absent postoperatively in all eyes, resulting in a smooth conjunctival surface and restored tear meniscus. At the 3-month follow-up visit, 91.4% of patients reported improvement in symptoms. There were no recurrences or significant complications.
  
  
  CONCLUSIONS
  The present retrospective, noncomparative, consecutive, interventional case series study introduces paste-pinch-cut conjunctivoplasty as a simple and an effective surgical treatment for the repair of CCh in symptomatic patients.
authors.affiliation: Loma Linda University, School of Medicine, Loma Linda, CA, USA.
authors.forename: Linden R
authors.initials: LR
authors.lastname: Doss
authors.forename: E Lauren
authors.initials: EL
authors.lastname: Doss
authors.forename: R Philip
authors.initials: RP
authors.lastname: Doss
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D003228:Conjunctiva / Q000187:drug effects / Q000601:surgery*; D003229:Conjunctival Diseases / Q000601:surgery*; D005260:Female; D015718:Fibrin Tissue Adhesive / Q000008:administration & dosage*; D006801:Humans; D056965:Injections, Intraocular; D008297:Male; D013508:Ophthalmologic Surgical Procedures; D012189:Retrospective Studies; D014014:Tissue Adhesives / Q000008:administration & dosage*; D016896:Treatment Outcome
chemical_list: D015718:Fibrin Tissue Adhesive; D014014:Tissue Adhesives