Blinking is vital to maintain the integrity of the ocular surface and its characteristics such as blink duration and speed can vary significantly, depending on the health of the eyes. The blink is so rapid that special techniques are required to characterize it. In this study, a high-speed camera was used to record and characterize voluntary blinking. The blinking motion of 25 healthy volunteers was recorded at 600 frames per second. Master curves for the palpebral aperture and blinking speed were constructed using palpebral aperture versus time data taken from the high-speed camera recordings, which show that one blink can be divided into four phases; closing, closed, early opening and late opening. Analysis of data from the high-speed camera images was used to calculate the palpebral aperture, peak blinking speed, average blinking speed and duration of voluntary blinking and compare it with data generated by other methods previously used to evaluate voluntary blinking. The advantages of the high-speed camera method over the others are discussed, thereby supporting the high potential usefulness of the method in clinical research.

Owing to the rapid movements of the human upper eyelid, a high-speed camera was used to record and characterize voluntary blinking and the blink dynamics of blepharoptosis patients were compared to a control group. Twenty-six blepharoptosis patients prior to surgery and 45 control subjects were studied and the vertical height of the palpebral aperture (PA) was measured manually at 2 ms intervals during each blink cycle. The PA and blinking speed were plotted with respect to time and a predictive model was generated. The blink dynamic was analysed in closing and opening phases, and revealed a reduced speed of the initial opening phase in ptotic patients, suggesting intrinsic muscle function change in ptosis pathogenesis. The PA versus time curve for each subject was reconstructed using custombuilt parameters; however, there were significant differences between the two groups. Those parameters used included the rate of closure, the delay between opening and closing, rate of initial opening, rate of slow opening (nonlinear function) and the 'switch point' between those two rates of opening. The model was tested against a new group of subjects and was able to discriminate ptosis patients from controls with 80% accuracy.

Levator palpebrae superioris (LPS) is a muscle responsible for lifting the upper eyelid and its malfunction leads to a condition called "ptosis", resulting in disfigurement and visual impairment. Severe ptosis is generally treated with "brow-suspension" surgery, whereby the eyelid is cross-connected to the mobile tissues above the eyebrow using a cord-like material, either natural (e.g. fascia lata harvested from the patient) or a synthetic cord. Synthetic brow-suspension materials are widely used, due to not requiring the harvesting of fascia lata that can be associated with pain and donor-site complications. The mechanical properties of some commonly-used synthetic brow-suspension materials were investigated--namely, monofilament polypropylene (Prolene®), sheathed braided polyamide (Supramid Extra® II), silicone frontalis suspension rod (Visitec® Seiff frontalis suspension set), woven polyester (Mersilene® mesh), and expanded polytetrafluoroethylene (Ptose-Up). Each material underwent a single tensile loading to the failure of the material, at three different displacement rates (1, 750 and 1500 mm/min). All the materials exhibited elastic-plastic tensile stress-strain behaviour with considerable differences in elastic modulus, ultimate tensile strength, elastic limit and work of fracture. The results suggest that, as compared to other materials, the silicone brow-suspension rod (Visitec® SFSS) might be the most suitable, providing relatively long-lasting stability and desirable performance. These findings, together with other factors such as commercial availability, cost and clinical outcomes, will provide clinicians with a more rational basis for selection of brow-suspension materials.

Poly-L-lactide (PLLA) is a popular choice for medical devices due to its bioresorbability and superior mechanical properties compared with other polymers. However, although PLLA has been investigated for use in bioresorbable cardiovascular stents, it presents application-specific limitations which hamper device therapies. These include low toughness and strength compared with metals used for this purpose, and slow degradation. Blending PLLA with novel polyethylene glycol functionalised poly(L-lactide-co-ε-caprolactone) (PLCL-PEG) materials has been investigated here to tailor the mechanical properties and degradation behaviour of PLLA. This exciting approach provides a foundation for a next generation of bioresorbable materials whose properties can be rapidly tuned. The degradation of PLLA was significantly accelerated by addition of PLCL-PEG. After 30 days of degradation, several structural changes were observed in the polymer blends, which were dependent on the level of PLCL-PEG addition. Blends with low PLCL-PEG content displayed enthalpy relaxation, resulting in embrittlement, while blends with high PLCL-PEG content displayed crystallisation, due to enhanced chain mobility brought on by chain scission, also causing embrittlement. Moderate PLCL-PEG additions (10% PLCL(70:30)-PEG and 20-30% PLCL(80:20)-PEG) stabilised the structure, reducing the extent of enthalpy relaxation and crystallisation and thus retaining ductility. Compositional optimisation identified a sweet spot for this blend strategy, whereby the ductility was enhanced while maintaining strength. Our results indicate that blending PLLA with PLCL-PEG provides an effective method of tuning the degradation timescale and mechanical properties of PLLA, and provides important new insight into the mechanisms of structural relaxations that occur during degradation, and strategies for regulating these.

Fused filament fabrication (FFF) is an inexpensive way of producing objects through a programmed layer-by-layer deposition. For multi-layer, macro-scaled prints, acceptable printing is achieved provided, amongst other factors, first layer adhesion is sufficient to fix a part to the surface during printing. However, in the deposition of structures with a single or few layers, first layer consistency is significantly more important and is an issue that has been previously overlooked. As layer-to-bed adhesion is prioritised in first layer printing, thin layer structures are difficult to remove without damage. The deposition of controllable thin structures has potential in tissue engineering through the use of bioactive filaments and incorporation of microfeatures into complex, patient-specific scaffolds. This paper presents techniques to progress the deposition of thin, reproducible structures. The linear thickness variation of 3D-printed single PVA and PLLA layers is presented as a function of extrusion factor and the programmed vertical distance moved by the nozzle between layers (the layer separation). A sacrificial PVA layer is shown to significantly improve first layer consistency, reducing the onus on fine printer calibration in the deposition of single layers. In this way, the linear variation in printed single PLLA layers with bed deviation is drastically reduced. Further, this technique is used to demonstrate the printing of freestanding thin layers of ~25 µm in thickness.