Lachlan D Farmer1, Saul N Rajak, Alan A McNab, Thomas G Hardy, Dinesh Selva. 1. *South Australian Institute of Ophthalmology, University of Adelaide, Adelaide, South Australia; †Department of Ophthalmology, Royal Adelaide Hospital, Adelaide, South Australia; ‡Orbital, Plastic and Lacrimal Service, Royal Victoria Eye and Ear Hospital, East Melbourne, Victoria; §Centre for Eye Research Australia, East Melbourne, Victoria; and ‖Department of Surgery, The University of Melbourne, Parkville, Victoria, Australia.
Abstract
PURPOSE: To describe a surgical procedure and its outcomes for the management of chronic pseudomembranous kerato-conjunctivitis secondary to giant fornix syndrome (GFS). METHODS: Retrospective case series of 6 patients undergoing fornix shortening surgery for giant fornix syndrome. RESULTS: Surgery produced complete resolution of symptoms in 5/6 (83%) patients and complete relief prior to partial relapse in 1. Mean follow up was 18 months (range: 3-41 months). In the 4 (of 6) patients who had measurements taken, the mean upper eyelid forniceal depth reduced from 21.25 mm (n = 4, SD: 2.87) preoperatively to 16.5 mm (n = 4, SD: 2.65) postoperatively. CONCLUSIONS: Fornix reconstruction may be an effective and well-tolerated treatment for refractory GFS. Resection of excess conjunctiva restores the normal anatomy within the conjunctival cul-de-sac thereby reducing the incidence of protein coagulum formation.
PURPOSE: To describe a surgical procedure and its outcomes for the management of chronic pseudomembranous kerato-conjunctivitis secondary to giant fornix syndrome (GFS). METHODS: Retrospective case series of 6 patients undergoing fornix shortening surgery for giant fornix syndrome. RESULTS: Surgery produced complete resolution of symptoms in 5/6 (83%) patients and complete relief prior to partial relapse in 1. Mean follow up was 18 months (range: 3-41 months). In the 4 (of 6) patients who had measurements taken, the mean upper eyelid forniceal depth reduced from 21.25 mm (n = 4, SD: 2.87) preoperatively to 16.5 mm (n = 4, SD: 2.65) postoperatively. CONCLUSIONS: Fornix reconstruction may be an effective and well-tolerated treatment for refractory GFS. Resection of excess conjunctiva restores the normal anatomy within the conjunctival cul-de-sac thereby reducing the incidence of protein coagulum formation.