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Facial nerve palsy (FNP) leads to an inability to blink. The exposed eye is at risk of developing corneal keratopathy and currently there is a lack of solution to active eye closure that is immediate and reliable. Bionic Lid Implant for Natural Closure (BLINC) proposes the use of an implantable actuator combined with the effects of an eyelid sling for dynamic eye closure. The aims of this thesis are to 1) explore the clinical need for BLINC, 2) describe the BLINC technology, and 3) present the results of its application in cadaveric and live models. Methods The aims of this project are addressed in three parts. In part one, the current therapies addressing key clinical end points in FNP from an ocular perspective and the setting where BLINC may first be used are explored. In part two the science behind BLINC is outlined. Finally in part three application of BLINC in cadaveric and live models are studied followed by a discussion on future steps preceding a pilot study in humans. Results Patients with FNP consistently identify issues related to the eye a primary concern. Current reanimation strategies offer the possibility of dynamic eye closure but the results are delayed and often unpredictable. BLINC reliably achieves active eye closure in cadaveric models by means of a wireless-powered, implantable electromagnetic actuator in conjunction with an eyelid sling. BLINC closes the eye in a similar fashion to natural closure for a symmetrical blink in FNP. Successful application of an inactive device in its complete form is achieved in a live animal without significant morbidity. Conclusion BLINC offers the possibility of restoring active eye closure with use of an implantable actuator. The concept has been successfully demonstrated in cadaveric models with successful device implantation in a live model. Future live trials are needed to address the remaining biocompatibility issues in preparation for human application. |
