Purpose

To determine whether superficial conjunctival cauterisation is an effective treatment in the management of epiphora when conjunctivochalasis is present.

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Methods

Multi-centre retrospective cohort study of conjunctival cautery in the management of epiphora with evidence of conjunctivochalasis. Patients were treated by a single Oculoplastic Consultant across 3 surgical centres in the South West of the UK over an 18-month period. Superficial thermal cautery using a high temperature cautery pen was applied over the area of loose conjunctiva that was impeding the flow of tears to the punctum. The electronic patient record was reviewed for each patient. Basic demographics were recorded, including a history of previous procedures to treat epiphora and any procedures carried out concurrently with the cauterisation. The patient reported outcomes and complications were recorded.

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Results

36 cauterisation procedures in 22 patients were carried out over the study period. 68% of the patients were female, with an average age of 70 years. 10 patients had previous surgical procedures for the management of epiphora but experienced persistent symptoms. 16 cauterisations were carried out concurrently with other procedures, and 20 were carried out in isolation. 31 (86%) eyes experienced an improvement in symptoms following conjunctival cauterisation, of which 20 (65%) reported a total resolution. In those who received cauterisation alone, 95% had an improvement in symptoms, of which 58% reported a complete resolution. There were no reported complications.

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Conclusion

Superficial conjunctival cautery to areas of conjunctivochalasis that are impeding the flow of tears to the punctum is a safe and effective treatment option for carefully selected patients with epiphora.

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Additional Authors

First name	Last name	Base Hospital / Institution
Dilen	Marian	Royal Berkshire NHS Trust
Adam	El Nairree	Swansea University
Aminah	Jawaheer	Musgrove Park Hospital

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