CCh is often found between the globe and lower eyelid, but in severe cases can be observed in the superior and even the whole bulbar conjunctiva 2, 12. CCh comprises redundant conjunctival folds characterized by loose and non-edematous bulbar conjunctiva that accumulate between the eyeball and the eyelid margin 2, 11. CCh is most common in elderly individuals and is one of the most common co-morbid conditions in patients with dry eye disease (DED) 3, 4, 5, 6, 7, 8, 9, 10. Particularly, management for MGD should be maintained after CCh correction.Ĭonjunctivochalasis (CCh) is a chronic condition of the ocular surface (OS), and its prevalence increases with age 1, 2. Younger patients with nasal CCh are likely to experience more symptomatic relief after HFR-ES. Therefore, CCh should be corrected in patients with DED and MGD. Collectively, CCh associated with MGD severity deteriorates not only tear film stability and reservoir capacity, leading to DED exacerbation. Ocular surface parameters significantly improved, but MGD-related signs did not. Patient age and preoperative nasal LIPCOF were determinants of outcomes associated with postoperative improvements in symptoms. One month following HFR-ES, CCh was completely resolved in all cases. Independent significant factors associated with total LIPCOF included CFS, tear break-up time, and MGD stage. Central, temporal, and total LIPCOF significantly correlated with MG loss, MGD stage, and lipid layer thickness. Nasal LIPCOF significantly correlated with symptoms and tear volume. Corneo-conjunctival fluorescein staining score (CFS) and all lid-parallel-conjunctival-folds scores (LIPCOFs) were positively correlated. As a result, patients with CCh had moderate to severe DED and most of them exhibited meibomian gland dysfunction (MGD). Forty patients diagnosed with symptomatic CCh were prospectively enrolled. We aimed to determine the clinical impact of conjunctivochalasis (CCh) and its correction using high-frequency radiowave electrosurgery (HFR-ES), for signs and symptoms of dry eye disease (DED).

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