Floppy eyelid syndrome: Clinical findings and results of lateral pentagonal eyelid resection

Abstract

Purpose: To report the demographic and clinical characteristics of patients with floppy eyelid syndrome and to review the results of eyelid shortening through lateral pentagonal eyelid resection.Material and Method: Thirty patients who had been diagnosed with floppy eyelid syndrome between January 2001 and January 2009 in two clinical centers were evaluated retrospectively. Presenting symptoms, examination findings, body mass index, associated systemic problems, surgical results and follow-up time were recorded. Surgical correction of horizontal laxity was performed on 23 upper eyelids of 15 patients by full-thickness lateral pentagonal wedge resection.Result: Fifty-eight upper eyelids of 30 patients (mean age, 59 years) were induded in the study. Irritation (93%) and epiphora (79%) were the most common presenting symptoms. Based on body mass index, 20 patients (67%) were obese and 19 patients (63%) had a history of obstructive sleep apnea. After surgery, ocular surface symptoms significantly resolved or decreased in all eyes. In 1 eye (4%), in which ocular complaints recurred, a secondary eyelid shortening procedure was required for residual lid laxity 12 months after the first surgery. Follow-up time ranged from 2 to 37 months (mean, 15 months).Discussion:The results of this study support the idea that obesity and/or sleep apnea syndrome occur more frequently in patients with floppy eyelid syndrome and eyelid shortening with lateral pentagonal resection is an effective treatment method.