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Bulgarian Review of Ophthalmology

Surgical treatment of floppy eyelids—a triple procedure

Milena Sredkova



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.



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

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About The Author

Milena Sredkova
Medical center in ophthalmology Resbiomed