Changes in tarsal plate fibrillar collagens and elastic fibre phenotype in floppy eyelid syndrome

Ezra, Daniel G.; Ellis, J. S.; Gaughan, Christine; Beaconsfield, Michele; Collin, Richard; Bunce, Catey; Bailly, Maryse; Luthert, Philip J.

doi:10.1111/j.1442-9071.2011.02506.x

Cited by 27 publications

(12 citation statements)

References 36 publications

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“…As we have shown previously using a range of ocular cells, including fibroblasts isolated from scarred tissue, 20 , 21 our in vitro contraction assay using soft collagen gels is a good reflection of the potential of the cells for scarring in vivo. 20 , 28 , 30 This implies that, upon tissue injury and local release of cytokines, presternal cells may have an inherent ability to generate more contracture and scarring—an observation in accord with clinical experience. Interestingly, when the cells’ properties were analyzed within more physiological engineered tissues at tensional homeostasis, resting presternal fibroblasts were found to have a lower intrinsic cellular contractile force compared with eyelid cells, generating a tissue of overall slightly lower stiffness.…”

Section: Discussionmentioning

confidence: 71%

“…This behavior is reminiscent of that of fibrotic fibroblasts isolated from the conjunctiva of patients with Floppy Eyelid Syndrome, whereby the diseased fibroblasts displayed increased collagen matrix contraction abilities, 21 despite the affected tissues of origin displaying a disorganized, much less stiff, matrix. 30 This suggests that whilst fibroblasts’ behavior is adaptable and intimately linked to tissue biomechanics, their propensity to scar may eventually be down to how they respond to the local stimuli upon wounding.…”

Section: Discussionmentioning

confidence: 99%

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Eyelid and Sternum Fibroblasts Differ in Their Contraction Potential and Responses to Inflammatory Cytokines

Li¹,

Roos²,

Rose³

et al. 2015

Plastic and Reconstructive Surgery - Global Open

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Background:Adverse skin scarring varies by anatomical site with, for example, presternal skin showing a greater hypertrophic response when compared with eyelid; such differences have traditionally been attributed to regional variations in skin tension, thickness, and Langer’s lines. Fibroblasts are the main cell implicated in fibrosis, and they too are known to show anatomical variation in their expression, differentiation, and intercellular interactions. We, therefore, investigated whether intrinsic differences in skin fibroblasts derived from separate locations might contribute to the observed discrepancies in clinical scarring.Methods:Primary in vitro cultures were established using matched eyelid and presternal skin from 3 healthy donors undergoing blepharoplasty surgery. We used an in vitro collagen gel model of fibroblast-mediated tissue contraction to compare the properties of the dermal fibroblasts from each site. Cell contractile force and matrix stiffness were assessed in 3-dimensional tissue constructs using an automated high-throughput device.Results:Dermal fibroblasts isolated from eyelid and sternum differ both in their ability to contract a gel matrix and in their response to cytokine stimulation; despite having lower intrinsic contractile force (P < 0.01) and resting stiffness (P < 0.02), the presternal cells were more contractile (P < 0.001) following stimulation with serum, or inflammatory cytokines transforming growth factor-β (P < 0.01) and interleukin-1β (P < 0.05).Conclusions:The propensity to cutaneous scarring may, at least in part, result from intrinsic differences in the local fibroblasts’ ability to contract and their sensitivity to inflammatory cytokines. Improved understanding of the underlying molecular pathways should prove useful in identifying new therapeutic targets for altering surgical and other scarring.

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Section: Discussionmentioning

confidence: 71%

Section: Discussionmentioning

confidence: 99%

Eyelid and Sternum Fibroblasts Differ in Their Contraction Potential and Responses to Inflammatory Cytokines

Li¹,

Roos²,

Rose³

et al. 2015

Plastic and Reconstructive Surgery - Global Open

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“…4,[6][7][8] The aetiology of FES is unknown, but histopathological studies have demonstrated altered tarsal plate elastic fibre phenotype and collagen accumulation. 8,9 At least in part, elastic fibre degradation occurs due to up-regulation of elastolytic matrix metalloproteinases, possibly induced by chronic nocturnal cyclical mechanical loading and hypoxia. 4,7,8,10 FES may be identified clinically using the Lateralising Eyelid Sleep Compression Study (LESCs) technique.…”

Section: Introductionmentioning

confidence: 99%

Floppy eyelid syndrome “plasty” procedure: Employment of a periosteal transposition flap for surgery of floppy eyelid syndrome

Waldie

Francis

Coroneo

et al. 2019

Clinical Exper Ophthalmology

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Importance Floppy eyelid syndrome “plasty” (FESplasty) is a surgical technique that addresses underlying superior tarsal plate and lateral canthal instability in floppy eyelid syndrome (FES) and aims to restore normal anatomical and physiological function to the upper eyelid. Background To describe the use of FESplasty in the surgical management of FES, and to report outcomes in an initial patient cohort. Design Retrospective study. Participants Seven patients (nine eyelids) with FES undergoing FESplasty. Methods A single surgeon (G.W.) performed all procedures. FESplasty utilizes a periosteal flap based at the inferolateral orbital rim, and applied to the anterior surface of the upper tarsal plate. It is combined with a titrated shortening procedure of the upper eyelid. Patient demographics, comorbidities and ocular symptoms and signs were recorded preoperatively. Pre‐ and postoperative upper eyelid distractibility were graded and documented. Main Outcome Measures Postoperative improvement in upper eyelid distractibility and symptomatology, operative complications and FES recurrence. Results FES symptoms and upper eyelid laxity improved at last follow‐up (average 24 weeks) in all patients, with no FES recurrences after a maximum follow‐up of 36 weeks. One patient, in whom FESplasty exacerbated his pre‐existing aponeurotic ptosis, required definitive ptosis surgery subsequently. There was one case of postoperative wound infection. Obstructive sleep apnoea was present in four of the seven patients. The remaining three patients were awaiting assessment. Conclusions and Relevance FESplasty is likely to confer long‐term effective stabilization of the lateral canthal tendon, lateral commissure and superior tarsal plate. Anatomical and functional results appeared to have been successfully achieved.

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“…ise tarsal dokudaelastik liflerdeki azalmaya kollajen 1 ve 3 yoğunluğundaki artışın eşlik ettiğini saptamışlardır. 24 Elastik lifte görülen bu değişimin uvulofaringoplasti uygulanan TUAS hastalarından elde edilen uvula dokusunda görülen değişimle benzerlik gös-termesi bu iki hastalık arasındaki ilişkiyi desteklemektedir. [23][24][25] Schlotzer-Schrehardt ve ark.…”

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“…24 Elastik lifte görülen bu değişimin uvulofaringoplasti uygulanan TUAS hastalarından elde edilen uvula dokusunda görülen değişimle benzerlik gös-termesi bu iki hastalık arasındaki ilişkiyi desteklemektedir. [23][24][25] Schlotzer-Schrehardt ve ark. ise yaptıkları çalışmada, tarsta ve göz kapağı derisinde elastin miktarında azalmayla birlikte elastolitik enzimlerden matriks metalloproteinaz (MMP)-7 ve 9'un aktivitesinin arttığını göstermişlerdir.…”

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Evaluation of Eyelid Laxity Changes in Patients with Obstructive Sleep Apnea Syndrome

Dikkaya¹,

Yıldırım²,

Benbir³

et al. 2016

Turkiye Klinikleri J Ophthalmol

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14ıkayıcı uyku apne sendromu (TUAS), uyku sırasında tekrarlayan üst solunum yolunun tamamen veya kısmi tıkanma atakları sonucu horlama, tanıklı apne ve gündüz aşırı uykululuk hâli ile şekillenen bir Tıkayıcı Uyku Apne Sendromu Hastalarında Göz Kapağı Laksite Değişimlerinin İncelenmesi Ö ÖZ ZE ET T A Am ma aç ç: : Tıkayıcı uyku apne sendromu (TUAS) hastalarında göz kapağı laksitesinde değişim, gevşek göz kapağı sendromu varlığı ve hastalık şiddeti ile oküler bulgular arasındaki ilişkiyi araştırmaktır. G Ge er re eç ç v ve e Y Yö ön nt te em ml le er r: : Uyku bozuklukları merkezinde polisomnografi cihazı ile inceleme sonucunda TUAS tanısı konulan 54 hasta çalışma kapsamında değerlendirildi. Hastalardan anormal solunum olayı indeksi 5-29 olan 21'i grup 1, >29 olan 33'ü ise grup 2 olarak sınıflandırıldı. Hastalar göz kapağı hiperlaksitesi ve gevşek göz kapağı sendromu(GGS)varlığı yönünden değerlendirildi. Gruplar elde edilen veriler açısından karşılaştırılırken, verilerin anormal solunum olayı indeksi, ortalama ve minimum oksijen satürasyonu ile olan ilişkileri de incelendi. B Bu ul lg gu ul la ar r: : Grup 1'deki hastaların %19'unda, grup 2'dekilerin %39,4'unde göz kapağı hiperlaksitesisaptandı. Göz kapağı hiperlaksitesi grup 2'de grup 1'e kıyasla iki kat fazla görülmesine karşın aradaki fark istatistiksel olarak anlamlı değildi (p=0,204). Gevşek göz kapağı sendromu grup 1'de hiç-bir hastada saptanmaziken, grup 2'de %21,2 oranında saptandı. Aradaki fark istatistiksel olarak anlamlı-yidi. (p=0,035). Göz kapağı laksitesindeki artış ile anormal solunum olayı indeksi'nin pozitif, minimum Oksijen satürasyonun ise negatif korelasyon gösterdiği saptandı (r=+0,250, r=-0,259). GGS varlığı ile anormal solunum olayı indeksi arasında pozitif korelasyon bulundu (r=+0,352). S So on nu uç ç: : TUAS hastalarında kapak laksitesinde ve Gevşek göz kapağı sendromu sıklığında artma meydana gelmekte ve bu değişimler TUAS'ninn ciddiyeti ile korelasyon göstermektedir.A An na ah ht ta ar r K Ke el li im me el le er r: : Uyku apnesi, tıkayıcı; göz kapakları; göz kapağı hastalıkları A AB BS ST TR RA AC CT T O Ob bj je ec ct ti iv ve e: : To investigate the prevalence of eyelid hyperlaxity, floppy eyelid syndrome (FES) in patients with obstructive sleep apnea syndrome (OSAS) and to determine the relation of ocular changes with the severity of the disease. M Ma at te er ri ia al l a an nd d M Me et th ho od ds s: : Fifty four patients were included in the study. Polysomnography was used to diagnose of OSAS. 21 patients with respiratory disturbance index respiratory disturbance index between 5-29 were included in group 1 and 33 patients with respiratory disturbance index >29 in group 2. The presence of hyperlaxity and FES was investigated in the patients. Number of patients with eyelid hyperlaxity and floppy eyelid syndrome in group 1 and 2 were compared and relation of respiratory disturbance index, mean and minimum oxygen saturation with the presence of eyelid hyperlaxity and floppy eyelid syndrome were evaluated. R Re es su ul lt ts s: : 19...

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Changes in tarsal plate fibrillar collagens and elastic fibre phenotype in floppy eyelid syndrome

Cited by 27 publications

References 36 publications

Eyelid and Sternum Fibroblasts Differ in Their Contraction Potential and Responses to Inflammatory Cytokines

Eyelid and Sternum Fibroblasts Differ in Their Contraction Potential and Responses to Inflammatory Cytokines

Floppy eyelid syndrome “plasty” procedure: Employment of a periosteal transposition flap for surgery of floppy eyelid syndrome

Evaluation of Eyelid Laxity Changes in Patients with Obstructive Sleep Apnea Syndrome

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