Tenon excision with fibrin glue-assisted reattachment of conjunctiva flap (T.E.F.A.R.C) for the treatment of conjunctivochalasis

Yi-Ting Hou; Bing-Jun Hsieh; Jo-Hsuan Wu; Wei-Lun Huang; Wei-Li Chen

doi:10.4103/tjo.TJO-D-23-00054

Tenon excision with fibrin glue-assisted reattachment of conjunctiva flap (T.E.F.A.R.C) for the treatment of conjunctivochalasis

Taiwan J Ophthalmol. 2023 Sep 8;13(3):366-370. doi: 10.4103/tjo.TJO-D-23-00054. eCollection 2023 Jul-Sep.

Authors

Yi-Ting Hou¹, Bing-Jun Hsieh¹, Jo-Hsuan Wu², Wei-Lun Huang^{3

4}, Wei-Li Chen^{1

5

6}

Affiliations

¹ Department of Ophthalmology, National Taiwan University Hospital, Taipei, Taiwan.
² Viterbi Family Department of Ophthalmology, Hamilton Glaucoma Center, Shiley Eye Institute, University of California, San Diego, California, USA.
³ Department of Ophthalmology, National Taiwan University Hospital Hsinchu Branch, Hsinchu, Taiwan.
⁴ Graduate Institute of Clinical Medicine, College of Medicine, National Taiwan University, Taipei, Taiwan.
⁵ Advanced Ocular Surface and Corneal Nerve Research Center, National Taiwan University Hospital, Taipei, Taiwan.
⁶ Department of Ophthalmology, College of Medicine, National Taiwan University, Taipei, Taiwan.

Abstract

To observe the surgical outcome of "Tenon Excision with Fibrin Glue-Assisted Reattachment of Conjunctiva Flap" (T.E.F.A.R.C.) for the treatment of symptomatic conjunctivochalasis (CCH). This is a retrospective case series of CCH patients undergoing T.E.F.A.R.C. from January 2017 to December 2020 were reviewed. Seven patients (14 eyes) with symptomatic CCH received T.E.F.A.R.C. in both eyes. The symptoms before and after the procedures were compared and surgical complication was evaluated. The mean follow-up time was 13.7 ± 2.14 months. After the operation, resolution of the symptoms was reported in 12 eyes (86%). The grade of CCH decreased from 3 to 0 in all 14 eyes, and the restoration of inferior conjunctival surface and fornix within 1 day was also observed in all eyes. Most patients had localized injection and mild chemosis after the operation, which mostly recovered within 3 weeks. No complication or recurrence of CCH was reported after 1 year of follow-up. In conclusion, T.E.F.A.R.C. is a simple and effective treatment option for CCH with less surgical complication. Future larger studies are needed to confirm its clinical applicability.

Keywords: Conjunctival flap; conjunctivochalasis; fibrin glue; fornix; tenon.