Topical Bimatoprost for Chemical Blepharoplasty
| Status: | Recruiting |
|---|---|
| Conditions: | Dermatology |
| Therapuetic Areas: | Dermatology / Plastic Surgery |
| Healthy: | No |
| Age Range: | 18 - Any |
| Updated: | 12/9/2016 |
| Start Date: | November 2016 |
| End Date: | March 2017 |
| Contact: | Megan P Couvillion, MD, MS |
| Email: | mcouvill@tulane.edu |
| Phone: | 5044732915 |
Topical bimatoprost has been shown to cause periorbital changes of soft tissue which are
most pronounced when used directly onto the cornea for the treatment of glaucoma. Changes
are primarily felt to be the result of prostaglandin-mediated adipocyte loss, resulting in
deepening of the upper eyelid sulcus and recession of infraorbital pseudoherniation. Use of
topical bimatoprost to the upper eyelid margin, now FDA approved for eyelash enhancement,
may provide a metered effect on the periocular tissues and allow for a topical approach to
periocular rejuvenation.
This is a proof of concept study which aims to enroll a series of patients with mild to
severe dermatochalasis, treat with topical bimatoprost 0.03% solution to the upper lid
margin, and evaluate for cosmetic improvement of the periocular area.
most pronounced when used directly onto the cornea for the treatment of glaucoma. Changes
are primarily felt to be the result of prostaglandin-mediated adipocyte loss, resulting in
deepening of the upper eyelid sulcus and recession of infraorbital pseudoherniation. Use of
topical bimatoprost to the upper eyelid margin, now FDA approved for eyelash enhancement,
may provide a metered effect on the periocular tissues and allow for a topical approach to
periocular rejuvenation.
This is a proof of concept study which aims to enroll a series of patients with mild to
severe dermatochalasis, treat with topical bimatoprost 0.03% solution to the upper lid
margin, and evaluate for cosmetic improvement of the periocular area.
Perception of beauty in the periocular region is influenced by several factors, including
symmetry, population norms, and skin texture and tone. Soft tissue and skin changes over
time create an aged appearance with the development of dermatochalasis, blepharoptosis,
lacrimal gland prolapse, and fat prolapse. Techniques for periocular rejuvenation are well
established and include soft tissue augmentation, resurfacing, and surgical correction. In
May 2015, Sarnoff and Gotkin reported a case of "chemical blepharoplasty" achieved with
topical bimatoprost ophthalmic 0.03% solution applied to the upper eyelid margin. After
three months of use, the author noted a more youthful appearance of the periocular region,
with deepening of the upper eyelid sulcus, reduction in dermatochalasis, and diminution of
the inferior eyelid fat pad. These changes were attributed to the prostaglandin associated
periorbitopathy (PAP), a well described phenomenon observed with the use of topical
prostaglandin analogues use for glaucoma.
Periorbital changes observed with topical prostaglandin analogues are primarily due to
effects on aponeurotic and deep orbital adipocytes. Prostaglandins activate the adipocyte
mitogen-activated protein kinase (MAPK) pathway, leading to inactivation of peroxisome
proliferator-activated receptor (PPAR)-gamma, inhibition of adipocyte differentiation, and
decreased fat accumulation within adipocytes. Bimatoprost concentration-dependent
contractions of ciliary muscles and activation of matrix metalloproteinases may also
contribute to periocular changes. Patients using topical ophthalmic prostaglandin analogues
commonly develop periorbital fat loss, which has been well characterized in the
ophthalmology literature.
Bimatoprost applied to the upper eyelid margin for eyelash enhancement attempts to
capitalize on the desirable effects of darker, longer, thicker eyelashes, while limiting
more significant and undesirable effects through limited exposure of the drug to ocular
tissues. This same concept may apply for dermatochalasis: at a metered dose, topical
bimatoprost to the lid margin could lead to subtle periorbital fat loss resulting in
improved dermatochalasis.
symmetry, population norms, and skin texture and tone. Soft tissue and skin changes over
time create an aged appearance with the development of dermatochalasis, blepharoptosis,
lacrimal gland prolapse, and fat prolapse. Techniques for periocular rejuvenation are well
established and include soft tissue augmentation, resurfacing, and surgical correction. In
May 2015, Sarnoff and Gotkin reported a case of "chemical blepharoplasty" achieved with
topical bimatoprost ophthalmic 0.03% solution applied to the upper eyelid margin. After
three months of use, the author noted a more youthful appearance of the periocular region,
with deepening of the upper eyelid sulcus, reduction in dermatochalasis, and diminution of
the inferior eyelid fat pad. These changes were attributed to the prostaglandin associated
periorbitopathy (PAP), a well described phenomenon observed with the use of topical
prostaglandin analogues use for glaucoma.
Periorbital changes observed with topical prostaglandin analogues are primarily due to
effects on aponeurotic and deep orbital adipocytes. Prostaglandins activate the adipocyte
mitogen-activated protein kinase (MAPK) pathway, leading to inactivation of peroxisome
proliferator-activated receptor (PPAR)-gamma, inhibition of adipocyte differentiation, and
decreased fat accumulation within adipocytes. Bimatoprost concentration-dependent
contractions of ciliary muscles and activation of matrix metalloproteinases may also
contribute to periocular changes. Patients using topical ophthalmic prostaglandin analogues
commonly develop periorbital fat loss, which has been well characterized in the
ophthalmology literature.
Bimatoprost applied to the upper eyelid margin for eyelash enhancement attempts to
capitalize on the desirable effects of darker, longer, thicker eyelashes, while limiting
more significant and undesirable effects through limited exposure of the drug to ocular
tissues. This same concept may apply for dermatochalasis: at a metered dose, topical
bimatoprost to the lid margin could lead to subtle periorbital fat loss resulting in
improved dermatochalasis.
Inclusion Criteria:
- 18+,
- mild to severe dermatochalasis, desire for enhanced eyelashes.
Exclusion Criteria:
- Patients with current use of ophthalmic prostaglandin analogues,
- history of blepharoplasty,
- history of neuromodulators or fillers to the periocular region or frontalis in the
last 6 months,
- existing deep upper eyelid sulcus,
- opposition to eyelash enhancement,
- pregnancy.
We found this trial at
1
site
New Orleans, Louisiana 70112
Principal Investigator: Megan P Couvillion, MD, MS
Phone: 504-473-2915
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