title: Is Floppy Eyelid Syndrome More Prevalent in Obstructive Sleep Apnea Syndrome Patients?
abstract: Controversial findings are reported about the relationship between floppy eyelid syndrome (FES) and obstructive sleep apnea syndrome (OSAS). The main goal of this study was to evaluate whether FES is more prevalent in OSAS patients by performing a meta-analysis. A comprehensive literature search of Pubmed, Embase, and Cochrane databases was performed. Only studies related to the prevalence of FES in OSAS were included in the meta-analysis. We estimated a pooled odds ratio (OR) for the prevalence of FES in OSAS. In total, 6 studies with 767 participants met the inclusion criteria. Using a fixed-effects model, the pooled OR was 4.12. The test for the overall effect revealed that FES was statistically prevalent in OSAS patients when compared with that in non-OSAS subjects (Z = 4.98, p < 0.00001). In the subgroup analysis by OSAS severity, the incidence of FES in OSAS increased with severity of OSAS as indicated with increased OR values (OR = 2.56, 4.62, and 7.64 for mild, moderate, and severe OSAS). In conclusion, the results indicate that FES is more prevalent in OSAS patients. However, this result was based only on unadjusted estimates. Prospective cohort studies are needed to determine whether OSAS is an independent risk factor for FES.
authors.affiliation: Department of Plastic Surgery, The Second Affiliated Hospital of Soochow University, 1055 Sanxiang Street, Suzhou, Jiangsu 215004, China; Department of Otolaryngology Surgery, Central Hospital of Fuxin, 74 Zhonghua Street, Fuxin, Liaoning 123000, China.
authors.forename: Ping
authors.initials: P
authors.lastname: Wang
authors.affiliation: Department of Plastic Surgery, The Second Affiliated Hospital of Soochow University, 1055 Sanxiang Street, Suzhou, Jiangsu 215004, China.
authors.forename: Dao-Jiang
authors.initials: DJ
authors.lastname: Yu
authors.affiliation: First Affiliated Hospital of Liaoning Medical University, Jinzhou, Liaoning 121000, China.
authors.forename: Gang
authors.initials: G
authors.lastname: Feng
authors.affiliation: Department of Cerebral-Neuro Surgery, Central Hospital of Fuxin, 74 Zhonghua Street, Fuxin, Liaoning 123000, China.
authors.forename: Zhen-Hai
authors.initials: ZH
authors.lastname: Long
authors.affiliation: Department of Cerebral-Neuro Surgery, Central Hospital of Fuxin, 74 Zhonghua Street, Fuxin, Liaoning 123000, China.
authors.forename: Chang-Jiang
authors.initials: CJ
authors.lastname: Liu
authors.affiliation: Department of Ophthalmology, Shanghai Jiaotong University Affiliated Sixth People's Hospital, Shanghai 200233, China.
authors.forename: Hui
authors.initials: H
authors.lastname: Li
authors.affiliation: Department of Plastic Surgery, The Second Affiliated Hospital of Soochow University, 1055 Sanxiang Street, Suzhou, Jiangsu 215004, China.
authors.forename: Tian-Lan
authors.initials: TL
authors.lastname: Zhao