Nanofiber‐based glaucoma drainage implant improves surgical outcomes by modulating fibroblast behavior

Abstract

Biomaterials are implanted in millions of individuals worldwide each year. Both naturally derived and synthetic biomaterials induce a foreign body reaction that often culminates in fibrotic encapsulation and reduced functional lifespan. In ophthalmology, glaucoma drainage implants (GDIs) are implanted in the eye to reduce intraocular pressure (IOP) in order to prevent glaucoma progression and vision loss. Despite recent efforts towards miniaturization and surface chemistry modification, clinically available GDIs are susceptible to high rates of fibrosis and surgical failure. Here, we describe the development of synthetic, nanofiber‐based GDIs with partially degradable inner cores. We evaluated GDIs with nanofiber or smooth surfaces to investigate the effect of surface topography on implant performance. We observed in vitro that nanofiber surfaces supported fibroblast integration and quiescence, even in the presence of pro‐fibrotic signals, compared to smooth surfaces. In rabbit eyes, GDIs with a nanofiber architecture were biocompatible, prevented hypotony, and provided a volumetric aqueous outflow comparable to commercially available GDIs, though with significantly reduced fibrotic encapsulation and expression of key fibrotic markers in the surrounding tissue. We propose that the physical cues provided by the surface of the nanofiber‐based GDIs mimic healthy extracellular matrix structure, mitigating fibroblast activation and potentially extending functional GDI lifespan.

Microfluidics in the eye: a review of glaucoma implants from an engineering perspective

“…Besides, the risk of intraocular toxicity induced by applying anti-fibrosis medication is lowered since the implantation site of the subconjunctival MIGS devices is out of the eye, which enables more flexible management of fibrosis or device obstruction. Notably, although the subconjunctival MIGS devices are effective in lowing IOP, they are still not suitable substitutes to 206 The shunt has a degradable PGA inner layer and a non-degradable PU outer layer. Scale bars are 100 μm (reproduced from ref.…”

“…Scale bars are 100 μm (reproduced from ref. 206 with permission from John Wiley and Sons, copyright 2023). f) Representation of a minimally invasive implantable valve-controlled drug-elutable microstent, including SEM images of the microstent with sealed inflow lumen and valve (region A), uncoated zone (region) and coated zone (region C) clearly labeled 207 (reproduced from ref.…”

“…d) The EX-PRESS, as an alternative to the classic trabeculectomy. e) Schematic and SEM images of the PCS 206. The shunt has a degradable PGA inner layer and a non-degradable PU outer layer.…”

“…The shunt has a degradable PGA inner layer and a non-degradable PU outer layer. Scale bars are 100 μm (reproduced from ref 206. with permission from John Wiley and Sons, copyright 2023).…”

Effective Needleless Electrospinning for the Production of Tubular Scaffolds

“…One of the advantages of electrospinning concerns a modification that enables the fabrication of applications with various shapes . The most commonly produced shapes concerning tissue engineering comprise planar samples that can be used, e.g., as wound dressings. − Other tubular shapes are also required for certain tissue engineering applications, including glaucoma drainage devices, − blood vessel replacements, − peripheral nerves, − urethra replacements, , etc.…”