My Conjunctivochalasis Surgery

My eye doctor compared my conjunctiva (the lining covering the front of the eye) to an old, worn-out carpet that has been pulled up over time. Prolonged inflammation and chronic dry eye contributed to its condition. He said that we might eventually need to do something about it if my intense pulsed light (IPL) procedures didn’t help tighten my conjunctiva back up.

Understanding the surgery

After three IPL procedures, my eyes still did not feel normal. On my fourth IPL procedure visit, my doctor advised that we move forward with a minor surgical procedure to help tighten up that loose tissue, called conjunctivochalasis. It is also known as mechanical dry eye (MDE) because it prohibits the eyes and tear flow from functioning mechanically as they should.

Folds in the conjunctiva stop the wet tears from disseminating across the eye, both worsening and mimicking dry eye symptoms. It also stops the meibum from being released as the eye blinks; this can cause that meibum to stay stagnant in the meibomian glands. My doctor discussed all of this information with me.

Undergoing it

I asked him about the procedure (as I had watched a YouTube video of it) and if I would be able to drive myself home (a five-hour drive) after it was finished. He said that I should be able to if I took breaks, but it wouldn’t be a bad idea to bring someone with me.

A month later I ended up bringing my husband with me for the procedure. My doctor does one eye at a time, so we decided to do my worse eye (the left one) first. I would have to go back a month later for the second eye. I have to admit that I was pretty nervous about the surgery. When I met with my doctor beforehand, he advised that I have a fifth IPL procedure before the surgery, so I did.

After that, I went into a room where I laid down on an operating bed. The doctor’s assistant taped a bandage over my right eye: the eye that would not be done. Then the doctor came in and administered some numbing drops. Next, he inserted a speculum into my eye to hold my eyelids open so that I would not blink. After that, he advised me to look up, and he inserted a needle into the lower outside corner of my eye to numb the site of the surgery.

What it felt like

I took a deep breath and concentrated on the ceiling tiles above and tried to go to my happy place. Honestly, I had a lot of anxiety about the speculum and the needle from the video that I had watched, but they really weren’t as scary as I thought they would be. All I felt was a little pressure from the needle.

The procedure itself involved my doctor pinching the fold in my conjunctiva with a tiny forcep-like tool and then cauterizing that tissue to help tighten it up. I didn’t even realize it was happening until I started smelling the burnt tissue. I guess I was expecting the cautery tool to be louder.

After a couple of minutes, the procedure was over, and my doctor removed the speculum. He put a gel-like substance over my eye, so my vision was a little blurry. Then I sat up and gathered my things. He gave me some steroid drops and antibiotic drops, both of which I was advised to use three times per day.

The aftermath

I was glad to have my husband there to drive me after the procedure because I now realize that I could not have driven myself very far immediately after the procedure. As the numbing wore off, my eye felt irritated and bulging – almost as if I couldn’t close it completely. All I wanted to do was close my eyes and rest them.

Over the next few days, my left eye still felt very irritated. By the fourth day, I started to feel a little relief, but my eye was still very red in the lower outside corner. (Also, my doctor told me not to pull my lower eyelid down to try to look at where he cauterized it, because that could pull on that tissue that he tightened.) My eyeball actually did feel very tight; that’s the best way I can describe it.

By about a week, almost all of the redness had gone away, and my eye felt close to normal, no longer tight-feeling – similar to how it felt before the procedure. As of my writing this at three weeks after the surgery, I am still waiting for the surgery’s beneficial effects. My eye still feels slightly inflamed and like it is still healing. Hopefully, as I continue to heal, I will feel some results.

My plans for the next one

In all, the procedure was not quite as scary as I had imagined, but the recovery was a little worse. When I go back for my next eye, I plan on spending the night in a hotel and driving myself home the next day. I think that I will be able to drive myself after a night’s sleep and during the morning hours.