Ophthalmology
Innovative Approach New Antibiotic-Loaded Intraocular Lens
Effectively Prevents and Treats Post-Cataract Endophthalmitis
Postoperative endophthalmitis is a serious complication of ocular surgery that can lead to vision loss and globe atrophy, commonly occurring after cataract surgery, with an incidence rate of 0.012% to 1.3% globally over the past 20 years. Current preventive methods for endophthalmitis include the use of antibiotic eye drops during the perioperative period and intracameral injection of antibiotics at the end of cataract surgery; however, these methods still face issues such as low bioavailability and short drug retention time. In recent years, researchers have focused on modifying intraocular lenses to load target drugs, allowing the lens to serve as a drug delivery system for sustained release of the target drug within the eye. However, reported methods for drug loading in intraocular lenses still face challenges such as insufficient drug loading capacity, short release times, increased implantation difficulty, potential cytotoxicity or adverse reactions from excess reagents, and the need to wash the prepared lenses before use.
To address the current challenges in preventing endophthalmitis and drug loading methods for intraocular lenses, Professor Yao Ke’s team decided to start “from scratch” to develop a novel antibiotic-loaded intraocular lens, PUA-GAT, with uniform distribution of antibiotics within the polymer.
Schematic Diagram of the Development Process for the Novel Drug-Releasing Intraocular Lens
The study utilized polyurethane acrylate as the main material, selected suitable reactive diluents, and combined photopolymerization with 3D printing technology to achieve rapid fabrication of the intraocular lens in a mild environment. The study found that this method ensures the activity of the target antibiotic during the polymerization and post-processing stages, with the antibiotic uniformly distributed within the crosslinked system without affecting the material’s microstructure.
Unlike previous approaches that modified and loaded drugs onto finished intraocular lenses, this research employed a novel “from scratch” approach to drug loading in intraocular lenses, developing a new type of intraocular lens using 3D printing technology that can be rapidly formed, with polyurethane acrylate as the main material, successfully incorporating the target antibiotic—gatifloxacin—uniformly within the crosslinked network, forming a drug release system that can be regulated by adjusting the raw material ratios. This research not only improved the drug loading capacity of the intraocular lens and optimized its release performance but also demonstrated its effective prevention and treatment of postoperative endophthalmitis through in vitro and in vivo experiments, while enhancing its mechanical properties and ensuring its optical performance and good biocompatibility. This research outcome provides a new option for the clinical prevention and treatment of postoperative endophthalmitis and suggests that the new drug loading method for intraocular lenses may offer new strategies for preventing other postoperative complications in cataract surgery. The novel antibiotic-releasing intraocular lens exhibits excellent drug release performance, alongside outstanding mechanical properties, optical performance, and biocompatibility, holding significant clinical application and translational prospects, providing a new solution for the prevention and treatment of postoperative endophthalmitis and new strategies for managing other ophthalmic postoperative complications.
References:
1. M. Li, K. Yao et al. A novel gatifloxacin-loaded intraocular lens for prophylaxis of postoperative endophthalmitis. Bioact Mater. 2022 Jun 2;20:271-285. doi: 10.1016/j.bioactmat.2022.05.032
2. Yao Ke, Li Mengna, Xu Jingwei, Xu Zhikang; An intraocular lens containing antibiotics and its manufacturing method; Patent No.: ZL201910376178.9
The team led by Professor Yao Ke at the Ophthalmology Center of the Second Affiliated Hospital of Zhejiang University and Zhejiang University Eye Hospital published an original research paper titled “A novel gatifloxacin-loaded intraocular lens for prophylaxis of postoperative endophthalmitis” in the prestigious journal Bioactive Materials (JCR Q1, top journal in the field of biomaterials, ranked first in materials science for biomaterials, 2020 IF: 14.593) and obtained a national invention patent (An intraocular lens containing antibiotics and its manufacturing method, Patent No.: ZL201910376178.9).
Professor Yao Ke from the Ophthalmology Center of the Second Affiliated Hospital of Zhejiang University and Professor Xu Zhikang from the Department of Polymer Science and Engineering at Zhejiang University are co-corresponding authors of this paper, with doctoral student Li Mengna from the Ophthalmology Center of the Second Affiliated Hospital of Zhejiang University as the first author.
For more details, click here to view.
Team Introduction
This research was strongly supported by Professor Xu Zhikang’s team from the Department of Polymer Science and Engineering at Zhejiang University and Professor Xie Tao from the School of Chemical Engineering and Bioengineering at Zhejiang University. The research was also funded by the National Natural Science Foundation and key research and development projects in Zhejiang Province.
Author Introduction
Corresponding Author: Yao Ke
Professor, Chief Physician, Doctoral Supervisor
Director of the Ophthalmology Center of the Second Affiliated Hospital of Zhejiang University, Dean of Zhejiang University Eye Hospital, and Director of the Zhejiang University Eye Research Institute. Academician of the International Academy of Ophthalmology, Special Expert of Zhejiang Province. Chairman of the Ophthalmology Branch of the Chinese Medical Association, President-elect of the Asia-Pacific Society of Cataract and Refractive Surgery, Executive Director of the International Council of Ophthalmology, Executive Director of the Chinese Medical Association, Editor-in-Chief of the Chinese Journal of Ophthalmology, and Leader of the Cataract and Refractive Surgery Group of the Ophthalmology Branch of the Chinese Medical Association, President of the Zhejiang Provincial Medical Association. As the first awardee, he has received three second-class National Science and Technology Progress Awards and three first-class Zhejiang Provincial Science and Technology Progress Awards. He has published 488 academic papers, of which 269 are included in SCI, and has obtained 7 national invention patents.
Corresponding Author: XU Zhikang
Professor, Doctoral Supervisor
Distinguished Professor at Zhejiang University, concurrently serving as Vice Chairman of the Zhejiang Chemical Society and Vice Chairman of the Zhejiang Membrane Society, Editorial Board Member of J. Membr. Sci./Research/Adv. Membr./Polymer Journal/Membrane Science and Technology, etc. He has long been engaged in fundamental and applied research on the surface and interface engineering of polymer separation membrane materials. He has edited three monographs in Chinese and English, has been granted over 70 Chinese invention patents, and has published over 450 academic papers, cited over 17,000 times, with an h-index of 75, and has been selected as an Elsevier Highly Cited Researcher for six consecutive years. His related achievements have received the second-class National Science and Technology Progress Award, first-class Zhejiang Provincial Natural Science Award, second-class Natural Science Award from the Ministry of Education, first-class Ningbo Science and Technology Progress Award, National Outstanding Youth Fund, and other honors.
Corresponding Author: Li Mengna
Doctoral Student, Zhejiang University School of Medicine
Medical Doctor, graduated from Zhejiang University, under the supervision of Professor Yao Ke. Main research directions: drug loading and drug release performance of ophthalmic implants, chemical synthesis and performance research of medical polymer materials, application of rapid prototyping technology in medical materials, congenital cataract SNP gene mutations and their functional studies. Participated in multiple national and provincial research projects, published one SCI paper as the first author in an internationally recognized academic journal, and obtained one national invention patent.
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