Dr. Shoaib Ugradar explains award-winning research on floppy eyelid syndrome

At the American Society of Ophthalmic Plastic & Reconstructive Surgery (ASOPRS) Fall 2021 Scientific Symposium, Shoaib Ugradar, MD, UCLA Stein Eye Center Santa Monica, will receive an award for his work on floppy eyelid syndrome and the use of collagen crosslinking to stiffen the skin Eyes preserve eyelids and help patients.


You will receive a research award at the ASOPRS 2021 Fall Scientific Symposium. What is the award for?

We received this award from ASOPRS, a highly respected organization, for our work on floppy eyelid syndrome. Well, floppy eyelid syndrome is a curious condition that, according to certain studies, affects up to about 10% of the population. And in this scenario, in patients with aging and obesity, there may be a decrease in the amount of elastin in the eyelids, which leads to the fact that the mechanical structure of the eyelid becomes flaccid. This in turn leads to eye irritation, eye exposure and ultimately, in severe cases, decrease or loss of vision.

What we have now done was collagen crosslinking, a technique that uses riboflavin, which is a B vitamin, and we spread it on the eyelid and emit a UV light [ultraviolet] Light directly on the eyelid itself. When the UV light hits the riboflavin at a certain frequency, it creates an almost magical chemical reaction that causes energy to be released over the entire eyelid. Now this free energy is converted into a covalent bond, which causes a crosslinking. And the collagen fibers inside the eyelids become more attached and densified tightly.

Now, if you look at the original paper we published, you will see beautiful electron microscopy photos that show that the collagen fibers are more closely spaced and more compact.

What does all this mean for floppy eyelid syndrome? This tight compression of the collagen fibers leads to a mechanical change. So here we have a chemical process that leads to a physical change in the tissue. So it is tissue engineering in the truest sense of the word. And we hope that eyelid stiffening will be a future treatment option to help patients with floppy eyelid syndrome.

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