title: The clinical characteristics and new classification of sticky eyelid syndrome in East Asian patients.
abstract: OBJECTIVE
  The aim of this study was to demonstrate the characteristics of sticky eyelid syndrome (SES) and to suggest a modified definition and new classification of the disease in relation to the severity of the syndrome in East Asian patients.
  
  
  METHODS
  Forty-four eyes of 31 patients with sticky eyelid syndrome were included in this study. The medical records of patients who were diagnosed with sticky eyelid syndrome were retrospectively reviewed. Sticky eyelid syndrome was defined as an abnormal adhesion between the upper and lower eyelids during blinking. We divided the subjects into four grades according to the severity of the disease.
  
  
  RESULTS
  Among 31 patients, there were 10 men and 21 women. The mean age of patients was 62.5 years. A total of 13 patients had SES bilaterally. All patients had meibomian gland dysfunction (MGD). Thirty-three eyes had dermatochalasis, and 30 eyes had involutional ptosis. Horizontal lower lid laxity was observed in 23 eyes, and reverse ptosis found in 15 eyes. Patients were classified into four groups as follows: G1: 11 (25%), G2: 24 (54.5%), G3: 6 (13.6%) and G4: 3 eyes (6.8%). Patients in Grade 1 tended to improve only with medical treatment for MGD. However, surgical management was necessary for patients in Grades 3 and 4.
  
  
  CONCLUSIONS
  Meibomian gland dysfunction is a fundamental risk factor for developing sticky eyelid syndrome. Further, combined upper lid ptosis or lower lid laxity may be aggravating factors. According to the grading, medical or surgical management can be chosen.
authors.affiliation: Department of Ophthalmology, Dongguk University Ilsan Hospital, Goyang, Korea.
authors.forename: Minwook
authors.initials: M
authors.lastname: Chang
authors.forename: Hwa
authors.initials: H
authors.lastname: Lee
authors.forename: Min Soo
authors.initials: MS
authors.lastname: Park
authors.forename: Sehyun
authors.initials: S
authors.lastname: Baek
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D044466:Asian People; D001763:Blepharoptosis / Q000175:diagnosis; D003430:Cross-Sectional Studies; D005141:Eyelid Diseases / Q000145:classification* / Q000175:diagnosis* / Q000601:surgery; D005260:Female; D006801:Humans; D008297:Male; D008537:Meibomian Glands / Q000473:pathology*; D008875:Middle Aged; D056910:Republic of Korea; D012189:Retrospective Studies; D013577:Syndrome; D009626:Terminology as Topic; D000267:Tissue Adhesions / Q000145:classification* / Q000175:diagnosis / Q000601:surgery
keywords: dermatochalasis; lower lid laxity; meibomian gland dysfunction; reverse ptosis; sticky eyelid syndrome; upper lid involutional ptosis