Suppression of fibroblast and bacterial adhesion by MPC coating on acrylic intraocular lenses

Mitigation of Cellular and Bacterial Adhesion on Laser Modified Poly (2-Methacryloyloxyethyl Phosphorylcholine)/Polydimethylsiloxane Surface

Nowadays, using polymers with specific characteristics to coat the surface of a device to prevent undesired biological responses can represent an optimal strategy for developing new and more efficient implants for biomedical applications. Among them, zwitterionic phosphorylcholine-based polymers are of interest due to their properties to resist cell and bacterial adhesion. In this work, the Matrix-Assisted Laser Evaporation (MAPLE) technique was investigated as a new approach for functionalising Polydimethylsiloxane (PDMS) surfaces with zwitterionic poly(2-Methacryloyloxyethyl-Phosphorylcholine) (pMPC) polymer. Evaluation of the physical-chemical properties of the new coatings revealed that the technique proposed has the advantage of achieving uniform and homogeneous stable moderate hydrophilic pMPC thin layers onto hydrophobic PDMS without any pre-treatment, therefore avoiding the major disadvantage of hydrophobicity recovery. The capacity of modified PDMS surfaces to reduce bacterial adhesion and biofilm formation was tested for Gram-positive bacteria, Staphylococcus aureus (S. aureus), and Gram-negative bacteria, Escherichia coli (E. coli). Cell adhesion, proliferation and morphology of human THP-1 differentiated macrophages and human normal CCD-1070Sk fibroblasts on the different surfaces were also assessed. Biological in vitro investigation revealed a significantly reduced adherence on PDMS-pMPC of both E. coli (from 29 × 10 ⁶ to 3 × 10² CFU/mL) and S. aureus (from 29 × 10⁶ to 3 × 10² CFU/mL) bacterial strains. Additionally, coated surfaces induced a significant inhibition of biofilm formation, an effect observed mainly for E. coli. Moreover, the pMPC coatings improved the capacity of PDMS to reduce the adhesion and proliferation of human macrophages by 50% and of human fibroblast by 40% compared to unmodified scaffold, circumventing undesired cell responses such as inflammation and fibrosis. All these highlighted the potential for the new PDMS-pMPC interfaces obtained by MAPLE to be used in the biomedical field to design new PDMS-based implants exhibiting long-term hydrophilic profile stability and better mitigating foreign body response and microbial infection.

Research Progress Concerning a Novel Intraocular Lens for the Prevention of Posterior Capsular Opacification

Posterior capsular opacification (PCO) is the most common complication resulting from cataract surgery and limits the long-term postoperative visual outcome. Using Nd:YAG laser-assisted posterior capsulotomy for the clinical treatment of symptomatic PCO increases the risks of complications, such as glaucoma, retinal diseases, uveitis, and intraocular lens (IOL) pitting. Therefore, finding how to prevent PCO development is the subject of active investigations. As a replacement organ, the IOL is implanted into the lens capsule after cataract surgery, but it is also associated with the occurrence of PCO. Using IOL as a medium for PCO prophylaxis is a more facile and efficient method that has demonstrated various clinical application prospects. Thus, scientists have conducted a lot of research on new intraocular lens fabrication methods, such as optimizing IOL materials and design, and IOL surface modification (including plasma/ultraviolet/ozone treatment, chemical grafting, drug loading, coating modification, and layer-by-layer self-assembly methods). This paper summarizes the research progress for different types of intraocular lenses prepared by different surface modifications, including anti-biofouling IOLs, enhanced-adhesion IOLs, micro-patterned IOLs, photothermal IOLs, photodynamic IOLs, and drug-loading IOLs. These modified intraocular lenses inhibit PCO development by reducing the residual intraoperative lens epithelial cells or by regulating the cellular behavior of lens epithelial cells. In the future, more works are needed to improve the biosecurity and therapeutic efficacy of these modified IOLs.

Antifouling Silicone Hydrogel Contact Lenses with a Bioinspired 2-Methacryloyloxyethyl Phosphorylcholine Polymer Surface

Inspired by the cell membrane surface as well as the ocular tissue, a novel and clinically applicable antifouling silicone hydrogel contact lens material was developed. The unique chemical and biological features on the surface on a silicone hydrogel base substrate were achieved by a cross-linked polymer layer composed of 2-methacryloyloxyethyl phosphorylcholine (MPC), which was considered important for optimal on-eye performance. The effects of the polymer layer on adsorption of biomolecules, such as lipid and proteins, and adhesion of cells and bacteria were evaluated and compared with several conventional silicone hydrogel contact lens materials. The MPC polymer layer provided significant resistance to lipid deposition as visually demonstrated by the three-dimensional confocal images of whole contact lenses. Also, fibroblast cell adhesion was decreased to a 1% level compared with that on the conventional silicone hydrogel contact lenses. The movement of the cells on the surface of the MPC polymer-modified lens material was greater compared with other silicone hydrogel contact lenses indicating that lubrication of the contact lenses on ocular tissue might be improved. The superior hydrophilic nature of the MPC polymer layer provides improved surface properties compared to the underlying silicone hydrogel base substrate.

Influence of super-hydrophobic silicone rubber substrate on the growth and differentiation of human lens epithelial cells

Materials with low cell adhesion are advantageous for production of replacement intraocular lens (IOL) to prevent posterior capsular opacification (PCO). We evaluated the feasibility of compression molding for manufacture of silicone rubber with super-hydrophobic surface and low cell infiltrative characteristics compared to ordinary hydrophobic silicone rubber. Silicone specimens with complex surface topology (super-hydrophobic) or smooth surfaces (hydrophobic) were manufactured by vacuum deforming and molding. Contact angle, microscopic surface structure, and transparency were evaluated. Super-hydrophobic and smooth samples were compared for effects on proliferation, adhesion, and morphology of human lens epithelial cells (hLECs). Epithelial-mesenchymal transition (EMT) was examined by immunofluorescence expression of fibronectin (Fn), Alpha-smooth muscle actin (α-SMA), and vimentin. The surface contact angle of super-hydrophobic silicone was greater than that of smooth silicone (153.8° vs. 116°). The super-hydrophobic surface exhibited a micron-scale palisade structure under scanning electron microscopy (unit length, width, and height of 80, 25, and 25 μm, respectively). However, cell number per 50 × microscopic field on super-hydrophobic surfaces was markedly reduced 24 and 72 h post-seeding compared to smooth surfaces (p < 0.01). Cells were cuboidal or spherical after 72h on super-hydrophobic surfaces, and exhibited numerous surface microvilli with fluff-base polarity, while cells on smooth surfaces exhibited morphological characteristics of EMT. Expression levels of the α-SMA and vimentin were reduced on super-hydrophobic surfaces compared to smooth surfaces. Super-hydrophobic silicon inhibits proliferation, adhesion, and EMT of hLECs, properties that may prevent fibrosis following cataract surgery.

Reductively Degradable Poly(2-hydroxyethyl methacrylate) Hydrogels with Oriented Porosity for Tissue Engineering Applications

Degradable poly(2-hydroxyethyl methacrylate) hydrogels were prepared from a linear copolymer (M_w = 49 kDa) of 2-hydroxyethyl methacrylate (HEMA), 2-(acethylthio)ethyl methacrylate (ATEMA), and zwitterionic 2-methacryloyloxyethyl phosphorylcholine (MPC). The deprotection of ATEMA thiol groups by triethylamine followed by their gentle oxidation with 2,2'-dithiodipyridine resulted in the formation of reductively degradable polymers with disulfide bridges. Finally, a hydrogel 3D structure with an oriented porosity was obtained by gelation of the polymer in the presence of needle-like sodium acetate crystals. The pore diameter and porosity of resulting poly(2-hydroxyethyl methacrylate-co-2-(acethylthio)ethyl methacrylate-co-2-methacryloyloxyethyl phosphorylcholine) [P(HEMA-ATEMA-MPC)] hydrogels varied between 59 and 65 μm and between 70 and 79.6 vol % according to Hg porosimetry, and complete degradation of these materials was reached in 86 days in 0.33 mmol solution of l-cysteine/L in phosphate buffer. The cross-linked P(HEMA-ATEMA-MPC) hydrogels were evaluated as a possible support for human mesenchymal stem cells (MSCs). No cytotoxicity was found for the un-cross-linked thiol-containing and protected P(HEMA-ATEMA-MPC) chains up to a concentration of 5 and 1 wt % in α-minimum essential medium, respectively.

Improvement of Uveal and Capsular Biocompatibility of Hydrophobic Acrylic Intraocular Lens by Surface Grafting with 2-Methacryloyloxyethyl Phosphorylcholine-Methacrylic Acid Copolymer

Biocompatibility of intraocular lens (IOL) is critical to vision reconstruction after cataract surgery. Foldable hydrophobic acrylic IOL is vulnerable to the adhesion of extracellular matrix proteins and cells, leading to increased incidence of postoperative inflammation and capsule opacification. To increase IOL biocompatibility, we synthesized a hydrophilic copolymer P(MPC-MAA) and grafted the copolymer onto the surface of IOL through air plasma treatment. X-ray photoelectron spectroscopy, atomic force microscopy and static water contact angle were used to characterize chemical changes, topography and hydrophilicity of the IOL surface, respectively. Quartz crystal microbalance with dissipation (QCM-D) showed that P(MPC-MAA) modified IOLs were resistant to protein adsorption. Moreover, P(MPC-MAA) modification inhibited adhesion and proliferation of lens epithelial cells (LECs) in vitro. To analyze uveal and capsular biocompatibility in vivo, we implanted the P(MPC-MAA) modified IOLs into rabbits after phacoemulsification. P(MPC-MAA) modification significantly reduced postoperative inflammation and anterior capsule opacification (ACO), and did not affect posterior capsule opacification (PCO). Collectively, our study suggests that surface modification by P(MPC-MAA) can significantly improve uveal and capsular biocompatibility of hydrophobic acrylic IOL, which could potentially benefit patients with blood-aqueous barrier damage.

Does pelvic mesh treated with phosphorylcholine improve outcomes? An early experience

OBJECTIVES

Implantable devices treated with phosphorylcholine (PC) have been successfully used in cardiac, ophthalmic, and other applications. This surface modification has resulted in a reduction in the host inflammatory responses. This pilot study tested the safety and efficacy of PC treated polypropylene mesh grafts implanted for the treatment of pelvic organ prolapse.

STUDY DESIGN

Surgeons from five U.S. sites collected data on subjects implanted with Perigee IntePro Lite+PC. Pre-procedure data collected included demographics and prolapse severity. At follow-up, subjects were assessed for anatomical outcomes (success≤stage I POPQ or Baden Walker), symptomatic improvement, and complications, particularly mesh exposure.

RESULTS

A total of 40 subjects were enrolled with 80% (32/40) of them completing at least 5-7 months of follow-up. Mean patient age was 60 years (range 36-78 years) and the mean BMI was 28 (range 20-40). There were no cases of mesh exposure/extrusion or granuloma formation. The anatomical success rate was 100% at 5-7 months (32/32).

CONCLUSIONS

This is the first publication on pelvic mesh treated with PC. There were no adverse events attributed to this surface modification. However, as the numbers are small, the results are not statistically significant. PC surface modification of pelvic mesh shows promise in its application for the reduction of mesh related complications.

Effect of gauge thickness on wound-width measurements in microincision cataract surgery

PURPOSE

To evaluate the effect of gauge thickness on wound-width measurement values in microincision cataract surgery (MICS).

SETTING

Kosei Chuo Hospital, Tokyo, Japan.

METHODS

For intraocular lens (IOL) implantation, the incision was enlarged with 1 of 2 knives of different widths. Before and after IOL insertion, the wound width was measured with a 0.15 mm thick gauge (F-gauge), which was the same thickness as both types of knife, and a commercially available 0.35 mm thick gauge (A-gauge).

RESULTS

In the 2.2 mm incision group, the mean wound width before IOL insertion was 2.20 mm+/-0.03 (SD) measured with the F-gauge and 2.16+/-0.05 mm measured with the A-gauge; the difference was statistically significant (P=.002). The mean wound width after IOL insertion was 2.41+/-0.08 mm using the F-gauge and 2.35+/-0.09 mm using the A-gauge; the difference was statistically significant (P<.0001). In the 2.4 mm incision group, the mean wound width before IOL insertion was 2.39+/-0.04 mm using the F-gauge and 2.31+/-0.06 mm using the A-gauge (P<.0001); the mean wound width after IOL insertion was greater than 2.5 mm in both groups.

CONCLUSIONS

In MICS, when the wound-width gauge thickness exceeded the knife thickness, the potential for measurement errors increased. Thus, a similar thickness between the 2 instruments may be preferable.

Surface modification of silicone intraocular lens by 2-methacryloyloxyethyl phosphoryl-choline binding to reduce Staphylococcus epidermidis adherence

PURPOSE

To analyse the in vitro adherence of Staphylococcus epidermidis to the 2-methacryloyl oxyethyl phosphorylcholine (MPC)-modified silicone intraocular lens (IOL).

METHODS

The test IOLs were modified by using an air plasma treatment to bind MPC to the surface. The control IOLs were not modified. Chemical changes on the IOL surface were analysed by X-ray photoelectron spectroscopy (XPS) to confirm the covalent binding of MPC. IOL hydrophilicity was determined by measuring the water contact angle. Two different techniques, direct counting of viable adherent bacteria released by sonication, and scanning electron microscopy (SEM), were used to observe and compare the adherence of S. epidermidis to the IOLs after 1- and 18-h incubation.

RESULTS

XPS analysis confirmed that the test IOLs were surface-modified with MPC. The hydrophilicity of the IOLs was improved by surface modification, and the MPC-modified IOLs exhibited significantly reduced adhesion of S. epidermidis (P = 0.002) after an incubation period of 1 h. The SEM results showed that the MPC modification also suppressed the accumulation of bacteria and biofilm production after 18 h incubation.

CONCLUSIONS

MPC-modified hydrophilic silicone IOLs reduce bacterial adherence and colonization, and thus may help reduce the incidence of postoperative endophthalmitis.