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Floppy Eyelid Syndrome Linked to Keratoconus, Sleep Apnea

Last Updated: April 09, 2010.

Floppy eyelid syndrome seems to be strongly associated with obstructive sleep apnea-hypopnea syndrome and keratoconus, and both medial canthal and lateral canthal plication and upper lid lateral tarsal strip provide better survival outcomes for floppy eyelid syndrome patients than full-thickness wedge excision, according to two studies published in the April issue of Ophthalmology.

FRIDAY, April 9 (HealthDay News) -- Floppy eyelid syndrome (FES) seems to be strongly associated with obstructive sleep apnea-hypopnea syndrome (OSAHS) and keratoconus, and both medial canthal and lateral canthal plication and upper lid lateral tarsal strip provide better survival outcomes for FES patients than full-thickness wedge excision, according to two studies published in the April issue of Ophthalmology.

In one study, Daniel G. Ezra, of the University College London Institute of Ophthalmology, and colleagues describe the features of patients with FES to understand the relationship of the condition with keratoconus, OSAHS, and other upper and lower eyelid features. The researchers evaluated 102 patients with FES and a matched control group of 102 patients. They found significant associations between FES and OSAHS, keratoconus, levator function, lash ptosis, upper lid medial canthal laxity, upper lid distraction, palpebral aperture, and dermatochalasis.

In another study, Ezra and colleagues assessed the effectiveness of four procedures for FES: full-thickness wedge excision, medial canthal and lateral canthal plication, upper lid lateral tarsal strip, and medial tarsal strip. They evaluated 71 patients who had undergone surgery for FES since 1995, as well as retrospective data from seven more patients. Medial canthal and lateral canthal plication and upper lid lateral tarsal strip provided superior long-term survival outcomes compared to full-thickness wedge excision.

"On the basis of experience from our unit, we recommend that the full-thickness wedge excision procedure be avoided as a form of treatment for FES in favor of the medial canthal and lateral canthal plication, lateral tarsal strip, or medial tarsal strip procedure," write the authors in the second study.

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