Surgical Techniques for Inferior Conjunctivochalasis: 

• Insert a 15 mm solid blade Speculum (K1-5014 Katena), apply
• Epinephrine (1:1000) for hemostasis and 2% lidocaine gel (Astra Zeneca) for Topical Anesthesia.
• Identify the location of CCh by grabbing the conjunctiva with 0.12 forceps (Fig. 4).
• Create an arc like conjunctival peritomy from 4 to 8 o’clock positions 1-2 mm posterior to the limbus (Fig. 5).
• Place 7-0 Vicryl Traction Suture 1-2 mm posterior to the limbus at the 6 o’clock position. Rotate the eye upward to allow the conjunctiva posterior to the peritomy to retract and expose the bare sclera.
• Excise a strip of fragile and wrinkled conjunctival tissue along with any underlying movable Tenon’s capsule (Fig. 6).
• Transplant Cryopreserved Amnion Graft with Fibrin Glue: Place the cryopreserved AmnioGraft on the bare sclera with the sticky/stromal surface facing down. Secure the membrane using fibrin glue while tucking the graft underneath the conjunctival edge and sealing the conjunctiva over the graft (Fig.7).

Click here to view a presentation titled "Conjunctivochalasis Surgical Steps"

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Click here to view a video titled "Conjunctivochalasis Surgery with Sutures"

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