Drug interaction with intraocular lenses of different materials

Abstract

The uptake and washout kinetics of four drugs representing different classes of ophthalmic medications were measured in intraocular lenses of different materials. The materials ranged from hydrogel lenses to poly(methyl methacrylate) (PMMA), Acrysof (acrylic/methacrylic), and two types of silicone lenses (Chiroflex and AMO SI-18NB). Uptake was determined after seven days of immersion in a large volume of Ringer's solution containing drug concentrations that equaled those found in aqueous humor 30 minutes to one hour after topical administration. Washout was determined after placing lenses in 1 ml of 0.9% saline for 24 hours. Only hydrogel lenses could be digested in acid to measure lens uptake directly. The PMMA, Acrysof, and silicone lenses behaved similarly toward gentamicin and dexamethasone--low uptake (less than 3.5 ng/mg lens) and low washout (less than 4.0%). Their uptake of norepinephrine was lower (less than 0.7 ng/mg lens) but the washout varied from 29% (AMO silicone) to 100% (PMMA and Acrysof). The pilocarpine uptake was the lowest of drugs tested (less than 0.03 ng/mg lens) and the washout varied from 1.5% (acrylic) to 100% (PMMA and Chiroflex silicone). Hydrogel lenses took up the most drug in the following order: dexamethasone greater than pilocarpine greater than gentamicin greater than norepinephrine. Washout was high, ranging from 83% to 98%. Despite the greater uptake and washout, the maximum drug uptake would only provide one-tenth of the greatest aqueous humor concentration that occurs after topical drug administration. Intraocular lenses of the materials tested did not interfere with the intraocular drug pharmacokinetics, nor did the data indicate that presoaking intraocular lenses of these materials in drugs would enhance post-surgical intraocular drug concentrations.

Case-control study for clinical findings on intraocular lens opacity

“…21,22 The interaction of ophthalmic medications was also related with intraocular lenses opacification of different materials. 23 However, we did not find any correlation with systemic medications reported by the patients of both groups and the opacified IOLs.…”

Hydrophilic acrylic intraocular lens as a drug-delivery system for fourth-generation fluoroquinolones

“…We cannot rule out the development of a delayed toxic reaction. Unpreserved gatifloxacin (Tequin) at a higher concentration Several studies [13][14][15] have investigated the ability of IOLs to absorb and release different medications. The concept in these studies was to load the IOLs with drugs after implantation in the eye using topical administration.…”

Hydrophilic acrylic intraocular lens as a drug-delivery system: Pilot study

“…Although they all conclude that IOLs cannot serve as a drug reservoir, the hydrogel IOLs proved capable of absorbing different types of medications and releasing most of the absorbed medication (83% to 98%). 16 In these studies, the concentrations of the drugs released from the hydrogel lenses were low and without clinical significance. The concept in all these studies was to load the IOLs with the drugs after the implantation by topical drop administration.…”

“…(One drop of topical antibiotic was applied at the end of surgery to the control rabbit.) Several studies [14][15][16] have investigated the ability of IOLs to absorb and release different medications. Although they all conclude that IOLs cannot serve as a drug reservoir, the hydrogel IOLs proved capable of absorbing different types of medications and releasing most of the absorbed medication (83% to 98%).…”