A swollen polysaccharide multilayer was coated on an IOL to inhibit LEC adhesion and proliferation, thus decreasing PCO incidence after implantation.

A new kind of bio-inspired terpolymer was synthesized by a conventional free radical terpolymerization of dopamine methacrylamide (DMA), 2-(dimethylamino)-ethyl methacrylate (DMAEMA) and 2-methacryloyloxyethyl phosphorylcholine (MPC) with azobisisobutyronitrile (AIBN) as an initiator.

BackgroundPosterior capsular opacification (PCO) is the main complication after intraocular lens (IOL) implantation in cataract surgery, which is the result of lens epithelial cell (LEC) adhesion, proliferation and migration on the IOL and at the lens capsule interface. Hydrophilic surface modification, such as surface heparinization, decreases the cell adhesion, which has been commercialized and used clinically. However, clinical long-term observation results show no significant difference between the pristine and heparinized IOLs.MethodsTo prevent PCO over the long time span, we modified the IOLs with an antiproliferative drug-loaded hydrophilic coating. The antiproliferative drug doxorubicin (DOX)-incorporated chitosan (CHI) nanoparticle was fabricated by sodium tripolyphosphate (TPP) gelation. Such antiproliferative drug-loaded CHI-TPP-DOX nanoparticles (CTDNP) were used as one of the building blocks to prepare polyelectrolyte multilayer with heparin (HEP) via layer-by-layer assembly, obtaining (HEP/CTDNP)n multilayers. The assembly process was characterized by quartz crystal microbalance with dissipation (QCM-D). The drug release behavior of the coating was investigated by ultra-HPLC (UPLC). In vitro cell experiments were carried out to monitor the effects of multifunctional coatings on cellular adhesion, proliferation and migration. And the intraocular implantation was performed on rabbits to evaluate the in vivo PCO inhibitory effect of such surface-functionalized IOLs.ResultsThe positively charged CTDNP was successfully prepared by ionic gelation. The QCM-D results indicate the successful preparation of the (HEP/CTDNP)n multilayer film. Drug release profiles showed that surface-multifunctionalized IOL had drug-sustained release properties. In vitro cell culture results showed significant inhibition of adhesion, proliferation and migration of LECs after surface modification. The in vivo results showed that the IOLs with multifunctionalized surface can effectively reduce the posterior hyperplasia and Soemmering’s ring (SR) formation.ConclusionThese findings suggested that such multifunctionalized drug-eluting IOLs can effectively reduce the posterior hyperplasia and SR formation when intraocular implantation has a major impact on reducing PCO incidence. Thus they have a great potential in improving patient vision recovery and maintenance.

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Posterior capsule opacification is one of the complications of cataract surgery caused by the adhesion and reproduction of residual human lens epithelial cells (HLECs) on the posterior capsule.

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Poly(methyl methacrylate) (PMMA) has been widely used for intraocular lenses (IOL) but may lead to posterior capsule opacification (PCO) after implantation due to its undesirable hydrophilicity and surface morphology. A novel methacrylisobutyl polyhedral oligomeric silsesquioxane-co-poly methyl methacrylate copolymer (MA POSS-PMMA) was synthesized by a free radical polymerization method to improve its material properties and cytocompatibility. Fourier transform infrared spectroscopy (FT-IR), X-ray diffraction (XRD) and proton nuclear magnetic resonance spectroscopy ( 1 H NMR) measurements demonstrated the successful synthesis of MA POSS-PMMA copolymer. The incorporation of MA POSS greatly changed the crystal structure, surface wettability, optical transmission and cytocompatibility of PMMA. XRD peaks at 2q $ 38.5, 44.7 and 66.1 indicated that a portion of the MA POSS molecules had aggregated and crystallized. Furthermore, larger aggregates are formed at higher MA POSS contents. The optical transmission of the copolymers was up to 99%, which was better than pure PMMA. The hydrophilicity and morphology of the IOL surface were characterized by static water contact angle and atomic force microscopy. Results revealed that MA POSS rendered the surface more hydrophobic and with higher roughness than the pure PMMA. Biocompatibility of copolymers with human lens epithelial cells (HLECs) was further evaluated by morphology and activity measurements in vitro. More HLECs adhesion and better spreading morphology on the surfaces of MA POSS-PMMA copolymers than that on PMMA was shown.