Posters

Keratoconus associated with the floppy eyelid syndrome: a cause of corneal collagen cross-linking failure

Poster Details

First Author: I.Elboukhani MOROCCO

Co Author(s): I. Errachiq   M. Essakhi   A. Mchachi   L. Benhmidoune   R. Rachid   M. Elbelhadji     

Abstract Details

Purpose:

Floppy eyelid syndrome FES is a condition strongly associated with keratoconus. The characteristic findings are an upper lid that may be readily everted, tarsal laxity, and diffuse papillary conjunctival changes. The cause of floppy eyelid syndrome is believed to be a mechanical disorder due to the eversion of the lids while sleeping. Aim of the study: Patient with floppy eyelid syndrome who had CXL for keratoconus in both eyes, an increase in the keratometric values indicating keratoconus progression (CXL failure) was seen in the eye with the more prominent floppy eyelid syndrome.

Setting:

Adult Ophthalmology Service, Hospital AUGUST 20, 1953, Ibn Rochd University Hospital, Hassan II University, Faculty of Medicine and Pharmacy of Casablanca

Methods:

We report the case of a patient with binocular FES in which after  uneventful bilateral corneal cross-linking (CXL) treatment. No intraoperative or early postoperative complications were found.

Results:

Topographic examination after CXL revealed a continuous increase in the keratometric values in the right eye in which the floppy eyelid syndrome was more prominent, indicating keratoconus progression (CXL failure). We suggested that possibly the flaccid eyelids could be easily everted during sleeping prone on the affected side and allow mechanical contact with bed sheets, finally leading to keratoconus progression even in a crosslinked cornea. Interestingly, the fellow eye (with the less prominent FES) was stable during every follow-up, indicating that the CXL failure was probably due to a biomechanical effect rather than a possible systemic alteration.

Conclusions:

Independent of the nature of decreased corneal biomechanics in patients with FES, primary or secondary, we would like to highlight that these patients should be followed closely with corneal topography, especially during puberty, because of possible progression of ectasia.

Financial Disclosure:

None