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Surgical Management With Conjunctivoplasty

Manoj M. Thakker, MD; Kristin J. Tarbet, MD; Bryan S. Sires, MD, PhD

Arch Facial Plast Surg. 2005;7:185-188.

Persistent conjunctival chemosis in patients who have undergone cosmetic eyelid surgery is an uncommon but aesthetically undesirable and potentially debilitating postoperative complication. We attempted to determine if a regional conjunctivoplasty can effectively reduce signs and symptoms of chronic postoperative chemosis in these patients. Three patients with iatrogenic chemosis resistant to conservative management (ie, lubrication, pressure patching, and steroid drops) and persisting for more than 6 months after the initial surgery were included. A limbal peritomy followed by subconjunctival and sub-Tenon’s fascia dissection was performed in regions of clinically detectable chemosis. Patients were followed postoperatively for 3 to 9 months to assess clinical response. All patients demonstrated significant objective improvement in clinically observable chemosis as well as symptoms related to ocular surface dryness.

Author Affiliations: Departments of Ophthalmology (Drs Thakker and Sires) and Otolaryngology–Head and Neck Surgery (Dr Sires), University of Washington, Seattle; and Department of Ophthalmology, Virginia Mason Medical Center, Seattle (Drs Thakker and Tarbet).