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New eyelid treatment pioneered by Aussie researchers

16/05/2018By Matthew Woodley
Australian researchers have developed a potential new method for treating floppy eyelid syndrome (FES) which could revolutionise the way it is currently managed.

FES is related to obstructive sleep apnoea – a sleeping disorder characterised by paused or shallow breathing during sleep. The common condition involves the loss of the inherent rigidity of the upper or lower eyelids, which is lost due to possible changes in the structure and organisation of the constitutive fibrous proteins (elastin, collagen).


“This is the first treatment where if we can strengthen it, we’re inherently stopping it from being able to stretch again, which is really what the corneal guys are doing with the CCXL of the cornea.”
Dr Tai Smith, QEI

“FES can cause eye irritation, inflammation, and eyelid sagging, and may become a blinding condition if not treated,” lead researcher and ocuplastic surgeon Dr Tai Smith from the Queensland Eye Institute (QEI) said.

Current treatments involve eye shields and ointment during sleep, or the surgical tightening of the eyelid, but they often prove to be a stop-gap that only temporarily resolves the issue. Further surgical interventions are also not possible, as they can distort the eyelid too much and cause many other associated problems.

However, QEI’s researchers have tested a potential new method on ex vivo lamb tissue which they say shows promising results.

By soaking the eyelid’s tarsal plate in a solution of vitamin B2, then exposing it to ultraviolet radiation of a specific wavelength, the tissue was found to become more rigid due to a photochemical process that led to the stiffening of collagen. The findings indicated that the irradiation could be a safe procedure for treating FES.

Tai said he developed the concept after observing a similar process – corneal cross-linking (CCXL) – that surgeons utilise when treating keratoconus.

“This is the first treatment where if we can strengthen it, we’re inherently stopping it from being able to stretch again, which is really what the corneal guys are doing with the CCXL of the cornea,” Smith said.

“They’ve proven that they can freeze it in time so it doesn’t keep changing. If we can have the same success under the same mechanism and with the same sort of patients, it will be an awesome treatment.”

Ex vivo human clinical trials should commence within six months, pending ethics approval, and Tai said if everything goes to plan the procedure could be used on genuine patients within two years.

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