PURPOSE: To present a new surgical technique for severe, symptomatic conjunctivochalasis and our hypothesis of the pathogenesis of this condition. METHODS: Six eyes of three patients with conjunctivochalasis (average age +/-SD, 70.0 +/- 9.6 years; range, 56-78 years) were treated with a conjunctival fixation to sclera with three 6-0 Vicryl (Johnson & Johnson, New Brunswick, New Jersey) stitches, RESULTS: With a mean follow-up period of 209.5 days (range, 181-219 days), we achieved successful treatment in all eyes, with no recurrence of conjunctival folds. CONCLUSION: We successfully treated conjunctivochalasis with conjunctival fixation to sclera, which strongly suggests that conjunctival folds are caused by the folding and the elevating of loosely adherent bulbar conjunctiva of the lower eyelid. (C) 2000 by Elsevier Science Tnc. All rights reserved.