Extraocular Manifestations of Obstructive Sleep Apnea as a Potential Screening Tool for Perioperative Complications: A Case Control Study
- 20.10.2025
- Research
Erschienen in:
- Verfasst von
- Megan Folsom
- Juan Diaz
- Nick Lowe
- Abhinav Dronavalli
- Jason A. Sokol
- Radwan S. Ajlan
- Arun George
- Yoon Ji
- Niaman Nazir
- Erschienen in
- Obesity Surgery | Ausgabe 12/2025
Abstract
Background
Obstructive sleep apnea presents with a variety of potential intra- and post-operative complications; thus, adequate screening is needed to properly manage them. The gold standard for diagnosing OSA is polysomnography; however, due to access and practicality, alternative tools such as the STOP-BANG score are utilized. Another avenue to be investigated is the association between floppy eye syndrome (FES) and OSA. The aim of this study is to use STOP-BANG and FES to predict perioperative risk of complications arising from obstructive sleep apnea.
Methods
Prospective case-control study with 160 clinic participants was used in this study. Patients with known formal OSA diagnosis were excluded from the study. OSA was classified as a STOP-BANG score ≥ 3. FES was classified as grading ≥ 2. We took photographs while vertically and horizontally retracting the patient’s eyes. Two blinded ophthalmologists and two blinded anesthesiologists used a graded scale to classify eyelid laxity.
Results
A total of 32.5% of patients were in the experimental OSA group and 67.5% were in the control group. FES prevalence among the OSA group was 15% and 2% among control. Ophthalmologist reviewers showed a greater incidence of FES in the OSA group compared to control (p < 0.05), while anesthesiologist reviewers did not. Ophthalmologists and anesthesiologists exhibited significant specificity (93% and 98%, respectively) and positive predictive value (88% and 86%, respectively).
Conclusions
Using FES to determine probability of OSA, as determined by the STOP-BANG questionnaire, may have utility in the perioperative setting due to its high rule-in value as shown by high specificity and positive pressure ventilation (PPV).
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- Titel
- Extraocular Manifestations of Obstructive Sleep Apnea as a Potential Screening Tool for Perioperative Complications: A Case Control Study
- Verfasst von
-
Megan Folsom
Juan Diaz
Nick Lowe
Abhinav Dronavalli
Jason A. Sokol
Radwan S. Ajlan
Arun George
Yoon Ji
Niaman Nazir
- Publikationsdatum
- 20.10.2025
- Verlag
- Springer US
- Erschienen in
-
Obesity Surgery / Ausgabe 12/2025
Print ISSN: 0960-8923
Elektronische ISSN: 1708-0428 - DOI
- https://doi.org/10.1007/s11695-025-08211-x
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