Surgical approach with high-frequency radiowave electrosurgery for superior limbic keratoconjunctivitis

The aim was to introduce the application of a simple technique using high-frequency radiowave electrosurgery in the management of superior limbic keratoconjunctivitis (SLK).

This study is a prospective, noncomparative, interventional case series analysis. Seven patients (9 eyes) with SLK were recruited from the outpatient clinic of the Department of Ophthalmology, Severance Eye Hospital and Kangbuk Samsung Hospital, Seoul, Korea. On the superior bulbar conjunctiva, multiple ablations were performed using a high-frequency radiowave electrosurgical unit (Ellman Surgitron Dual Frequency RF; Ellman International, Inc, Hewlett, NY) with the lowest power setting of 1 (of 100) in the cutting mode. The operation was completed when the operator found no redundant portion on the superior bulbar conjunctiva.

After the surgery was performed, all the patients had mild to moderate superior conjunctival injection and swelling at the operating area. One month postoperatively, slit-lamp examinations revealed a smooth conjunctival surface without remarkable hyperemia. The symptoms were significantly improved in all eyes. Follow-up Fourier domain optical coherence tomography images showed a decrease of the space between subconjunctival tissue and sclera. No notable complications were observed.

This study demonstrated that high-frequency radiowave electrosurgery is a simple, safe, and effective first-line surgical treatment modality for refractory SLK patients with conjunctivochalasis.