title: A novel surgical technique for the treatment of giant fornix syndrome.
abstract: OBJECTIVE
  To describe a novel surgical treatment for patients with chronic relapsing conjunctivitis, corneal epitheliopathy, and ptosis secondary to giant fornix syndrome.
  
  
  METHODS
  A retrospective case series was performed looking at the presence or absence of preoperative symptoms of eye irritation, tearing, blurry vision, and discharge in 6 patients diagnosed with giant fornix syndrome. Their examination findings were noted, and all patients underwent an extensive conjunctivoplasty with resection of redundant forniceal conjunctiva with subconjunctival antibiotics. Final visual acuity, symptoms, and examination findings were noted with a minimum follow up of 9 months.
  
  
  RESULTS
  Six patients were treated from November 2009 to November 2011. Duration of symptoms ranged from 3 to 40 months. Four patients were women while 2 were men, with age ranging from 61 to 85 years. Common symptoms were severe mucopurulent discharge, eye redness, tearing, and irritation with examination findings of severe conjunctival discharge and injection, corneal epitheliopathy, upper eyelid ptosis, and a deep upper and lower eyelid fornix. Most patients had undergone previous treatments with topical and/or oral antibiotics or steroids. All patients underwent surgical intervention using the surgical technique to be described with resolution of their symptoms, and even an improvement of 2 or more lines of best corrected visual acuity (3 of 5 patients).
  
  
  CONCLUSIONS
  The authors' novel surgical technique helps restore the abnormal anatomy found in patients with giant fornix syndrome and thus, helps resolve chronic relapsing conjunctivitis and surface disease associated with this often underdiagnosed condition. Further studies are needed to evaluate the risk of entropion and dry eye syndrome due to the modification of the posterior lamella.
authors.affiliation: Department of Ophthalmology, The University of Alabama at Birmingham, Birmingham, AL 35209, USA. cnabavi@yahoo.com
authors.forename: Cameron B
authors.initials: CB
authors.lastname: Nabavi
authors.forename: John A
authors.initials: JA
authors.lastname: Long
authors.forename: Christopher J
authors.initials: CJ
authors.lastname: Compton
authors.forename: Matthew G
authors.initials: MG
authors.lastname: Vicinanzo
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D002437:Cefazolin / Q000627:therapeutic use; D002908:Chronic Disease; D003131:Combined Modality Therapy; D003234:Conjunctivitis, Bacterial / Q000188:drug therapy / Q000382:microbiology / Q000601:surgery*; D003315:Cornea / Q000502:physiology; D004564:Electrocoagulation; D005141:Eyelid Diseases / Q000188:drug therapy / Q000382:microbiology / Q000601:surgery*; D005260:Female; D006801:Humans; D008297:Male; D055624:Methicillin-Resistant Staphylococcus aureus / Q000302:isolation & purification; D008875:Middle Aged; D013508:Ophthalmologic Surgical Procedures; D012008:Recurrence; D012189:Retrospective Studies; D013203:Staphylococcal Infections / Q000188:drug therapy / Q000382:microbiology / Q000601:surgery*; D013211:Staphylococcus aureus / Q000302:isolation & purification; D013577:Syndrome; D014792:Visual Acuity / Q000502:physiology
chemical_list: D000900:Anti-Bacterial Agents; D002437:Cefazolin