Scientific Online Resource System

Bulgarian Review of Ophthalmology

Surgical treatment of floppy eyelids—a triple procedure

Milena Sredkova

Abstract

Introduction:

Floppy eyelid syndrome is a relatively rare disease, characterized by chronic eye inflammation, caused by unilateral or bilateral upper eyelid laxity.Middle-aged men with obesity and sleep apnea are most commonly affected, but the condition also occurs in women and children.

Aim: The aim of this article is to describe our technique for surgical treatment of floppy eyelids.

Materials and Methods: The surgical technique was implemented in 17 severe floppy eyelid cases (13 men, 4 women, 10 unilateral, 7 bilateral) for a period of 6 years with follow-up for a minimum of one year.

Results: The triple procedure consists of horizontal shortening of the upper eyelid, advancement or resection of the levator aponeurosis, shortening and reconstruction of the anterior eyelid lamella. In all cases stable horizontal and vertical eyelid position and regular eyelash route was achieved.

Conclusion: Combined pathology, characteristic for floppy eyelids, requires simultaneous surgical correction of each clinical feature, impairing the eyelid function.

 


Keywords

floppy eyelid, vertical traction test (VTT), eyelash ptosis, marginal reflex distance I (MRDI)

Full Text


References

Culbertson WW, Ostler HB. The floppy eyelid syndrome. Am J Ophthalmol. 1981;92(4):568-75. doi: 10.1016/0002-9394(81)90652-8.

Mojon DS, Goldblum D, Fleischhauer J, Chiou AG, Frueh BE, Hess CW, et al. Eyelid, conjunctival, and corneal findings in sleep apnea syndrome. Ophthalmology. 199;106(6):1182-5. doi: 10.1016/S0161-6420(99)90256-7.

De Gregorio A, Cerini A, Scala A, Lambiase A, Pedrotti E, Morselli S. Floppy eyelid, an under-diagnosed syndrome: a review of demographics, pathogenesis, and treatment. Ther Adv Ophthalmol. 2021;13:25158414211059247. doi: 10.1177/25158414211059247.

Dutton JD. Surgical management of floppy eyelid syndrome. Am J Ophthalmol 1985;99:557– 60.

Ezra DG, Beaconsfield M, Sira M, Bunce C, Shah-Desai S, Verity DH, Uddin J, Collin R. Long-term outcomes of surgical approaches to the treatment of floppy eyelid syndrome. Ophthalmology. 2010;117(4):839-46. doi: 10.1016/j.ophtha.2009.09.009.

Schwartz LK, Aguilar G. Floppy Eyelid Syndrome In: Roy FH, ed. Master Techniques in Ophthalmic Surgery. Baltimore, Md: Williams & Wilkins; 1995:409 –15.

Moore MB, Harrington J, McCulley JP. Floppy eyelid syndrome: management including surgery. Ophthalmology. 1986;94:184 – 8

Abenavoli FM, Lofoco G, DeGaetano C. A technique to correct floppy eyelid syndrome. Ophthalmic Plast Reconstr Surg. 2008;24(6):497-8. doi: 10.1097/IOP.0b013e31818b7745.

Compton CJ, Melson AT, Clark JD, Shipchandler TZ, Nunery WR, Lee HB. Combined medial canthopexy and lateral tarsal strip for floppy eyelid syndrome. Am J Otolaryngol. 2016;37(3):240-4. doi: 10.1016/j.amjoto.2016.01.007.

Lee CC, Lai HT, Kuo YR, Lee SS, Lai CS. Floppy eyelid syndrome: an unfamiliar entity for plastic surgeons. Ann Plast Surg. 2018;80(2S Suppl 1):S40-S47. doi: 10.1097/SAP.0000000000001311.

Waldie AM, Francis IC, Coroneo MT, Wilcsek G. Floppy eyelid syndrome "plasty" procedure: Employment of a periosteal transposition flap for surgery of floppy eyelid syndrome. Clin Exp Ophthalmol. 2019;47(7):864-70. doi: 10.1111/ceo.13560.

Kraker JA, Tooley AA, Rose GE, Wagner LH. Novel surgical approach to refractory eyelid imbrication. Eur J Plast Surg. 2022;45:333-6.

Periman LM, Sires BS. Floppy eyelid syndrome: a modified surgical technique. Ophthal Plast Reconstr Surg. 2002;18(5):370-2. doi: 10.1097/00002341-200209000-00009.

Mills DM, Meyer DR, Harrison AR. Floppy eyelid syndrome: quantifying the effect of horizontal tightening on upper eyelid position. Ophthalmology. 2007;114(10):1932-6. doi: 10.1016/j.ophtha.2007.01.037.




DOI: http://dx.doi.org/10.14748/bro.v67i1.8808

Refbacks

Font Size


About The Author

Milena Sredkova
Medical center in ophthalmology Resbiomed
Bulgaria

|