ArticleObesity surgery2025
Extraocular Manifestations of Obstructive Sleep Apnea as a Potential Screening Tool for Perioperative Complications: A Case Control Study.
Article in Obesity surgery, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
backgroundObstructive 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.
methodsProspective 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.
resultsA 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).
conclusionsUsing 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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