Biocompatibility in the development of silicone-hydrogel lenses

Surface and Antifouling Properties of a Biomimetic Reusable Contact Lens Material

A comprehensive in vitro and ex vivo study was conducted for a newly developed biomimetic silicone hydrogel contact lens material, lehfilcon A, with poly-(2-methacryloyloxyethyl phosphorylcholine) (PMPC) surface modification. In vitro studies, including Sudan Black staining and fluorescence imaging, were executed to assess the surface wettability and lipid deposition of contact lenses after simulated prolonged exposure. Additionally, the lens surface softness and lubricity were characterized by ex vivo studies, including atomic force microscopy and tribological testing. The PMPC-modified surface stayed hydrophilic and resisted lipid accumulation during the simulated wearing cycles. The coefficient of friction and surface modulus were maintained, even after 30 days of patient use. These findings demonstrate that the PMPC-modified material offers exceptional surface properties and antifouling performance, presenting an advancement in biomimetic contact lens technology.

Antimicrobial and antifouling hyaluronic acid-cobalt nanogel coatings built sonochemically on contact lenses

The wearing of contact lenses (CLs) may cause bacterial infections, leading in turn to more serious complications and ultimately vision impairment. In this scenario, the first step is the adhesion of tear proteins, which provide anchoring points for bacterial colonization. A possible solution is the functionalization with an antimicrobial coating, though the latter may also lead to sight obstruction and user discomfort. In this study, adipic acid dihydrazide-modified hyaluronic acid-cobalt (II) (HA-ADH-Co) nanogels (NGs) were synthesized and deposited onto commercial CLs in a single-step sonochemical process. The coating hindered up to 60 % the protein adsorption and endowed the CLs with strong antibacterial activity against major ocular pathogens like Staphylococcus aureus and Pseudomonas aeruginosa, reducing their concentration by around 3 logs. Cytotoxicity assessment with human corneal cells demonstrated viabilities above 95 %. The nanocomposite coating did not affect the optical power and the light transmission of the CLs and provided enhanced wettability, important for the wearer comfort.

Silicone hydrogel versus hydrogel soft contact lenses for differences in patient-reported eye comfort and safety: A Cochrane systematic review summary

SIGNIFICANCE

This work is significant because it is the first Cochrane systemic review that compares the comfort and safety of hydrogel and silicone hydrogel soft contact lenses (SCL).

PURPOSE

This study aimed to conduct a systemic review of randomized trials comparing the comfort and safety of silicone hydrogel and hydrogel SCLs.

METHODS

CENTRAL, MEDLINE Ovid, EMBASE.com , PubMed, LILACS, ClinicalTrials.gov , and World Health Organization International Clinical Trials Registry Platform were searched on or before June 24, 2022, to identify randomized clinical trials that compared silicone hydrogel and hydrogel SCLs.

RESULTS

Seven trials were identified and evaluated. One trial reported Ocular Surface Disease Index results, with the evidence being very uncertain about the effects of SCL material on Ocular Surface Disease Index scores (mean difference, -1.20; 95% confidence interval, -10.49 to 8.09). Three trials reported visual analog scale comfort score results, with no clear difference in comfort between materials, although results were of low certainty; trial results could not be combined because the three trials reported results at different time points. None of the included trials reported Contact Lens Dry Eye Questionnaire 8 or Standard Patient Evaluation of Eye Dryness scores. There was no evidence of a clinically meaningful difference (>0.5 unit) between daily disposable silicone hydrogel and hydrogel SCLs in corneal staining, conjunctival staining, or conjunctival redness (very low certainty evidence).

CONCLUSIONS

The overall evidence for a difference between all included silicone hydrogel and hydrogel SCL trials was of very low certainty, with most trials judged as having a high overall risk of bias. There was insufficient evidence to support recommending one SCL material over the other. Future well-designed trials are needed to generate high certainty evidence to further clarify differences in SCL material comfort and safety.

Silicone hydrogel versus hydrogel soft contact lenses for differences in patient-reported eye comfort and safety

BACKGROUND

Ocular discomfort is the leading cause of permanent discontinuation of soft contact lens (SCL) wear. Silicone hydrogel and hydrogel materials are the two major categories of SCLs, with silicone hydrogel materials being newer and more breathable than hydrogel materials. Whether comfort is associated with SCL material is controversial despite numerous studies. Similarly, the difference between these materials in terms of safety outcomes (e.g. frequency of microbial keratitis) is unclear.

OBJECTIVES

To evaluate the comparative effectiveness and safety of silicone hydrogel compared with hydrogel SCLs on self-reported comfort, dry eye test results, and adverse events in SCL-wearing adults 18 years of age or older.

SEARCH METHODS

The Cochrane Eyes and Vision Information Specialist searched the electronic databases for randomized controlled trials (RCTs). There were no restrictions on language or date of publication. We searched the Cochrane Central Register of Controlled Trials (CENTRAL, including the Cochrane Eyes and Vision Trials Register; 2022, Issue 6), MEDLINE Ovid, Embase.com, PubMed, LILACS (Latin American and Caribbean Health Science Information database), ClinicalTrials.gov, and World Health Organization (WHO) International Clinical Trials Registry Platform (ICTRP). We also searched the reference lists of identified studies, review articles, and guidelines for information about relevant studies that may not have been identified by our search strategy. Furthermore, we contacted investigators regarding ongoing trials. The most recent database search was conducted on 24 June 2022.

SELECTION CRITERIA

Our search selection criteria included RCTs, quasi-RCTs, and cross-over RCTs.

DATA COLLECTION AND ANALYSIS

We applied standard Cochrane methodology.

MAIN RESULTS

We included seven parallel-group RCTs conducted in the USA, the UK, Australia, Germany, India, and Turkey. A total of 1371 participants were randomized. The duration of SCL wear ranged from one to 52 weeks. Study characteristics and risk of bias The median number of participants per trial was 120 (interquartile range: 51 to 314), and the average age ranged from 20.7 to 33.0 years. Women represented the majority of participants (range 55% to 74.9%; 5 RCTs). Collectively, the included trials compared eight different silicone hydrogel SCLs with three different hydrogel SCLs. Five trials compared daily disposable SCLs, and two compared extended wear SCLs (worn for seven days and six nights). New SCL wearers were enrolled in three trials. Two trials included both new and established SCL wearers, and two trials did not report participants' history of SCL use. Five trials were sponsored by industry. We judged the overall risk of bias to be 'high' or 'some concerns' for the safety and efficacy outcomes. Findings One trial reported Ocular Surface Disease Index (OSDI) results, with the evidence being very uncertain about the effects of SCL material on OSDI scores (mean difference -1.20, 95% confidence interval [CI] -10.49 to 8.09; 1 RCT, 47 participants; very low certainty evidence). Three trials reported visual analog scale comfort score results, with no clear difference in comfort between materials, but the evidence was of very low certainty; trial results could not be combined because the three trials reported results at different time points. The evidence is very uncertain about the effect of SCL material on discontinuation of contact lens wear (risk ratio [RR] 0.64, 95% CI 0.11 to 3.74; 1 RCT, 248 participants). None of the included trials reported Contact Lens Dry Eye Questionnaire (CLDEQ-8) or Standard Patient Evaluation of Eye Dryness (SPEED) scores. There was no evidence of a clinically meaningful difference (> 0.5 unit) between daily disposable silicone hydrogel and hydrogel SCLs in corneal staining, conjunctival staining, or conjunctival redness (very low certainty evidence). Adverse events Very low certainty evidence from two trials comparing daily disposable SCLs suggested no evidence of a difference between lens materials in the risk of vision-threatening adverse events at one to four weeks (RR 0.68, 95% CI 0.08 to 5.51; 2 RCTs, 368 participants). Two trials comparing extended wear SCLs indicated that hydrogel SCLs may have a 2.03 times lower risk of adverse events at 52 weeks compared with silicone hydrogel SCLs (RR 2.03, 95% CI 1.38 to 2.99; 815 participants), but the certainty of evidence was very low.

AUTHORS' CONCLUSIONS

The overall evidence for a difference between all included silicone hydrogel and hydrogel SCLs was of very low certainty, with most trials at high overall risk of bias. The majority of studies did not assess comfort using a validated instrument. There was insufficient evidence to support recommending one SCL material over the other. For extended wear, hydrogel SCL may have a lower risk of adverse events at 52 weeks compared to silicon hydrogel. Future well-designed trials are needed to generate high certainty evidence to further clarify differences in SCL material comfort and safety.

Biomimetic-Engineered Silicone Hydrogel Contact Lens Materials

Contact lenses are one of the most successful applications of biomaterials. The chemical structure of the polymers used in contact lenses plays an important role in determining the function of contact lenses. Different types of contact lenses have been developed based on the chemical structure of polymers. When designing contact lenses, materials scientists consider factors such as mechanical properties, processing properties, optical properties, histocompatibility, and antifouling properties, to ensure long-term wear with minimal discomfort. Advances in contact lens materials have addressed traditional issues such as oxygen permeability and biocompatibility, improving overall comfort, and duration of use. For example, silicone hydrogel contact lenses with high oxygen permeability were developed to extend the duration of use. In addition, controlling the surface properties of contact lenses in direct contact with the cornea tissue through surface polymer modification mimics the surface morphology of corneal tissue while maintaining the essential properties of the contact lens, a significant improvement for long-term use and reuse of contact lenses. This review presents the material science elements required for advanced contact lenses of the future and summarizes the chemical methods for achieving these goals.

Evaluation of Celligent® Biomimetic Water Gradient Contact Lens Effects on Ocular Surface and Subjective Symptoms

This study aimed to evaluate the non-invasive and subjective symptoms associated with Lehfilcon A water gradient silicone hydrogel contact lenses with bacterial and lipid resistance technology. A prospective, longitudinal, single-centre, self-controlled study was conducted among silicone hydrogel contact lens wearers. Non-invasive analysis of the pre-lens tear film was performed using the Integrated Clinical Platform (ICP) Ocular Surface Analyzer (OSA), and the meibomian glands were evaluated with the Cobra® HD infrared meibographer. After 30 days of contact lens wear, the subjects were re-evaluated to determine the changes in conjunctival redness, subjective dry eye disease, tear meniscus height, lipid pattern, and non-invasive break-up time. Results showed that the lipid layer thickness decreased significantly from 2.05 ± 1.53 to 0.92 ± 1.09 Guillon patterns, and the tear meniscus height decreased from 0.21 ± 0.04 to 0.14 ± 0.03. The mean pre-lens non-invasive break-up time (NIBUT) significantly increased from 15.19 ± 9.54 to 25.31 ± 15.81 s. The standard Patient Evaluation of Eye Disease (SPEED) score also decreased from 7.39 ± 4.39 to 5.53 ± 4.83. The results suggest that Lehfilcon A significantly reduced lipid and aqueous tear film volume but improved break-up time and subjective dry eye symptoms.

Pre-Lens Tear Meniscus Height, Lipid Layer Pattern and Non-Invasive Break-Up Time Short-Term Changes with a Water Gradient Silicone Hydrogel Contact Lens

To evaluate pre-lens tear film volume, stability and lipid interferometry patterns with a silicone hydrogel water content contact lens, a novel, noninvasive, ocular-surface-analyzer technology was used. A prospective, longitudinal, single-center, self-control study was performed in daily or monthly replacement silicone hydrogel contact lens wearers. A tear film analysis was achieved with the Integrated Clinical Platform (ICP) Ocular Surface Analyzer (OSA) from SBM System. The subjects were reassessed, with the contact lens, after 30 min of wearing to quantify the volume, stability and lipid pattern of the short-term pre-lens tear film. Lipid layer thickness decreased from 2.05 ± 1.53 to 1.90 ± 1.73 Guillon patterns (p = 0.23). First pre-lens NIBUT decreased from 5.03 ± 1.04 to 4.63 ± 0.89 s (p = 0.01). Mean pre-lens NIBUT significantly increased from 15.19 ± 9.54 to 21.27 ± 11.97 s (p < 0.01). Lid opening time significantly increased from 26.36 ± 19.72 to 38.58 ± 21.78 s (p < 0.01). The silicone hydrogel contact lens with water gradient technology significantly increased the mean pre-lens NIBUT and lid opening time. Lehfilcon A suggested an improvement in contact lens wearers with tear film instability or decreased subjective symptoms of dry eye disease.

Biomimetic materials based on zwitterionic polymers toward human-friendly medical devices

This review summarizes recent research on the design of polymer material systems based on biomimetic concepts and reports on the medical devices that implement these systems. Biomolecules such as proteins, nucleic acids, and phospholipids, present in living organisms, play important roles in biological activities. These molecules are characterized by heterogenic nature with hydrophilicity and hydrophobicity, and a balance of positive and negative charges, which provide unique reaction fields, interfaces, and functionality. Incorporating these molecules into artificial systems is expected to advance material science considerably. This approach to material design is exceptionally practical for medical devices that are in contact with living organisms. Here, it is focused on zwitterionic polymers with intramolecularly balanced charges and introduce examples of their applications in medical devices. Their unique properties make these polymers potential surface modification materials to enhance the performance and safety of conventional medical devices. This review discusses these devices; moreover, new surface technologies have been summarized for developing human-friendly medical devices using zwitterionic polymers in the cardiovascular, cerebrovascular, orthopedic, and ophthalmology fields.

Silicone-containing thermoresponsive membranes to form an optical glucose biosensor

Glucose biosensors that could be subcutaneously injected and interrogated without a physically connected electrode and transmitter affixed to skin would represent a major advancement in reducing the user burden of...

Nanoscaled Morphology and Mechanical Properties of a Biomimetic Polymer Surface on a Silicone Hydrogel Contact Lens

Materials taking advantage of the characteristics of biological tissues are strongly sought after in medical science and bioscience. On the natural corneal tissue surface, the highly soft and lubricated surface is maintained by composite structures composed of hydrophilic biomolecules and substrates. To mimic this structure, the surface of a silicone hydrogel contact lens was modified with a biomimetic phospholipid polymer, poly(2-methacryloyloxyethyl phosphorylcholine) (PMPC), and the nanoscaled morphology and mechanical properties of the surface were confirmed with advanced surface characterization and imaging techniques under an aqueous medium. Concavities and convexities on the nanometer order were recognized on the surface. The surface was completely covered with a PMPC layer and remained intact even after 30 days of clinical use in a human ocular environment. The mechanical properties of the natural corneal tissue and the PMPC-modified surface were similar in the living environment, that is, low modulus and frictional properties comparable to natural tissues. These results show the validity of material preparation by biomimetic methods. The methodologies developed in this study may contribute to future development of human-friendly medical devices.

Advanced morphological analysis of siloxane-hydrogel contact lenses

The purpose of this work is to provide a better understanding of three-dimensional (3-D) surface texture of siloxane-hydrogel contact lenses (CLs) using atomic force microscopy (AFM) and stereometric analysis. The 3-D surface texture characterization of unworn/worn siloxane-hydrogel CLs made of Filcon V (I FDA group) was performed with stereometric analysis. The atomic force microscopy (AFM) measurements of surface roughness and micromorphology of CLs were made using a Nanoscope V MultiMode (Bruker) in intermittent-contact mode, in air, on square areas of 5 × 5 μm. Stereometric study of 3-D surface texture was made according with ISO 25178-2:2012 for CLrins (taken from the blister and rinsed with deionized water); CLss (preserved for 12 hr in saline solution and rinsed with deionized water); CLworn-smooth (worn for 8 hr and presenting the smooth type morphology), and CLworn-sharp (worn for 8 hr and presenting the sharp-type morphology). The 3-D surface texture of siloxane-hydrogel CLs was found to have specific morphological characteristics. Statistical parameters revealed local geometrical and morphological spatial structures at nanometer scale attributed to the specific interactions at the CLs surface. Before wear, the surface micromorphology of Filcon V CLs is regular with uniformly distributed microasperities and relatively small heights (Sq = 0.6 nm). After 12 hr in saline, it is found that the micromorphology changes relatively easily, but retaining the main morphological characteristics (Sq = 1.2 nm). After 8 hr of wear, there are two typical micromorphologies: smooth type, characterized by gutter structures and isolated microasperities (Sq = 2.5 nm), while the sharp type has an appearance with compactly arranged microasperities of hill type flanked by compactly arranged microregions of valley type (Sq = 2.2 nm). Surface statistical parameters allow manufacturers in developing the next generation of CLs with improved surface texture while improving biocompatibility and minimizing the impact of the material on corneal physiology. Furthermore, the micro-elastohydrodynamic lubrication due to surface texture at a nanometer scale between the back surface of the CL with the corneal surface and the front surface of the CL with the under-surface of the eyelid can be deeper and more nuanced to understand in light of modern tribological theories.

Evaluation of silicone hydrogel contact lenses based on poly(dimethylsiloxane) dialkanol and hydrophilic polymers

Silicone hydrogel lenses were prepared by copolymerizing PDMS-PEGMA macromer (PGP) with various combinations of DMA, NVP, and PEGMA through UV initiated polymerization process. The resultant PGP macromer were characterized by gel permeation chromatography (GPC), and scanning electron microscope (SEM-EDS). Characterization of all the resultant co-polymers included Fourier transform infrared spectroscopy (FTIR), atomic force microscopy (AFM), equilibrium water content (EWC), oxygen permeability (Dk), optical transparency, contact angle, mechanical properties, zeta potential, protein deposition, and cytotoxicity. The results show that higher content of hydrophilic polymers increased water uptake ability as well as improved hydrophilicity and modulus of silicone hydrogel lenses; however, oxygen permeability decreased with the decrease of PDMS content (145 barrers of PGP to 37 barrers of DP0). In addition, these silicone hydrogel lenses exhibited relatively optical transparency, anti-protein deposition, and non-cytotoxic according to an in vitro L929 fibroblast assay. Therefore, these silicone hydrogel polymers would be applicable for making contact lens.

Micromechanical measurement of adhesion of dehydrating silicone hydrogel contact lenses to corneal tissue

Adhesion properties, which can vary with multiple factors, of silicone hydrogel contact lenses are important to their performance and comfort in the eye. In this study, we developed and used a simple, representative testing system and method to study the adhesive interactions of different silicone contact lenses (balafilcon A and senofilcon A) on polished titanium alloy and porcine whole eye cornea under dehydrating conditions. Adhesive interactions for senofilcon A varied by hydration state for both corneal and titanium adhesion, starting low, rising to a maximum and falling with dehydration time and dehydration state. Balafilcon A showed a rise and fall against titanium, but retained a relatively constant adhesive interaction with corneal tissue over dehydration time. Senofilcon A reached the highest adhesion forces (400 mN) within 5 to 10 min of testing against cornea, then dropped with time after that. Johnson-Kendall-Roberts (JKR) theory was applied to determine the surface energy of the lenses, and work of adhesion (WOA) was also determined for both lenses. Similar trends as observed with the force-hydration curves were seen with surface energy and work of adhesion as well (peak surface energy of 8 N/m and work of adhesion of 80 µJ for senofilcon A). Video imaging of the adhesive interactions showed significant corneal deformation taking place during testing, and post-test analysis shows damage to the corneal tissue. This method could be used to assess pre-clinical performance of long-lasting contact lenses and the role of hydration state. STATEMENT OF SIGNIFICANCE: Adhesion properties of contact lenses play significant roles in their performance and comfort in the eye. Adhesion is influenced by polymer chemistry, counterface materials and hydration state of the contact lenses. However, no test method has been developed to directly study the adhesion properties between contact lenses and corneal tissue during the dehydration process. Our work aims to fill this gap by developing testing and analysis methods for evaluating the adhesive interactions in vitro between contact lenses of different chemistries and properties and different counter surfaces under dehydrating conditions over time. Our study shows that adhesive interactions of contact lenses are highly dependent on polymer type, surface treatment, counterface material and hydration state.

Fouling in ocular devices: implications for drug delivery, bioactive surface immobilization, and biomaterial design

The last 30 years has seen a proliferation of research on protein-resistant biomaterials targeted at designing bio-inert surfaces, which are prerequisite for optimal performance of implantable devices that contact biological fluids and tissues. These efforts have only been able to yield minimal results, and hence, the ideal anti-fouling biomaterial has remained elusive. Some studies have yielded biomaterials with a reduced fouling index among which high molecular weight polyethylene glycols have remained dominant. Interestingly, the field of implantable ocular devices has not experienced an outflow of research in this area, possibly due to the assumption that biomaterials tested in other body fluids can be translated for application in the ocular space. Unfortunately, progression in the molecular understanding of many ocular conditions has brought to the fore the need for treatment options that necessitates the use of anti-fouling biomaterials. From the earliest implanted horsehair and silk seton for glaucoma drainage to the recent mini telescopes for sight recovery, this review provides a concise incursion into the gradual evolution of biomaterials for the design of implantable ocular devices as well as approaches used to overcome the challenges with fouling. The implication of fouling for drug delivery, the design of immune-responsive biomaterials, as well as advanced surface immobilization approaches to support the overall performance of implantable ocular devices are also reviewed.

Surface characterization of a silicone hydrogel contact lens having bioinspired 2-methacryloyloxyethyl phosphorylcholine polymer layer in hydrated state

A silicone hydrogel contact lens material, with a unique chemical and physical structure has been designed for long-term ocular performance. Enhancement of this silicone hydrogel contact lens material was achieved through surface modification using a cross-linkable bioinspired 2-methacryloyloxyethyl phosphorylcholine (MPC) polymer, which creates a soft surface gel layer on the silicone hydrogel base material. The surface properties of this MPC polymer-modified lens were characterized under hydrated condition revealing, inter alia, its unique polymer structure, excellent hydrophilicity, lubricity, and flexibility. Analysis of the MPC polymer layer in a hydrated state was performed using a combination of a high-resolution environmental scanning electron microscopy and atomic force microscopy. Compared to the silicone hydrogel base material, this surface had a higher captive bubble contact angle, which corresponds to higher hydrophilicity of the surface. In addition, the hydrated MPC polymer layer exhibited an extremely soft surface and reduced the coefficient of friction by more than 80 %. These characteristics were attributed to the hydration state of the MPC polymer layer on the surface of the silicone hydrogel base material. Also, interaction force of protein deposition was lowered on the surface. Such superior surface properties are anticipated to contribute to excellent ocular performance.

The Ophthalmic Performance of Hydrogel Contact Lenses Loaded with Silicone Nanoparticles

In this study, silicone nanoparticles (SiNPs) were prepared from polydimethylsiloxane (PDMS) and tetraethyl orthosilicate (TEOS) via the sol-gel process. The resultant SiNPs were characterized by dynamic light scattering (DLS), transmission electron microscope (TEM), and scanning electron microscope (SEM). These SiNPs were then blended with 2-hydroxyethylmethacrylate (HEMA) and 1-vinyl-2-pyrrolidinone (NVP) before polymerizing into hydrogel contact lenses. All hydrogels were subject to characterization, including equilibrium water content (EWC), contact angle, and oxygen permeability (Dk). The average diameter of SiNPs was 330 nm. The results indicated that, with the increase of SiNPs content, the oxygen permeability increased, while the EWC was affected insignificantly. The maximum oxygen permeability attained was 71 barrer for HEMA-NVP lens containing 1.2 wt% of SiNPs with an EWC of 73%. These results demonstrate that by loading a small amount of SiNPs, the Dk of conventional hydrogel lenses can be improved greatly. This approach would be a new method to produce oxygen-permeable contact lenses.

Tuning corneal epithelial cell adhesive strength with varying crosslinker content in silicone hydrogel materials

Purpose

To quantify the effect of silicone hydrogel crosslink density on the adhesion at corneal epithelial cells/silicone hydrogel contact lens interface.

Methods

A custom-built rheometer, referred to as the live cell monolayer rheometer, was used to measure the adhesive strengths between corneal epithelial cell monolayers and silicone hydrogel lens surfaces. The resulting stress relaxations of senofilcon A-derived silicone hydrogel materials with varying crosslinking densities and delefilcon A were tested. Senofilcon A-like materials labeled L1, L2, L3, L4, and L5 contained crosslinker concentrations of 1.2, 1.35, 1.5, 1.65, and 1.8 wt%, respectively. The residual modulus measured from the live cell monolayer rheometer provided a direct indication of adhesive attachment.

Results

Within the senofilcon-derived series, the adhesive strength shows a surprising minimum with respect to crosslink density. Specifically, L1 (1.20%) has the highest adhesive strength of 39.5 ± 11.2 Pa. The adhesive strength diminishes to a minimum of 11.2 ± 2.1 Pa for L3, whereafter it increases to 14.5 ± 2.5 Pa and 18.1 ± 5.1 Pa for L4 and L5, respectively. The delefilcon A lens exhibits a comparable adhesive strength of 27.8 ± 6.3 Pa to L1.

Conclusions

These results demonstrated that increasing the crosslink density has a nonmonotonic influence on the adherence of lenses to mucin-expressing corneal epithelial cells, which suggests a competition mechanism at the cell/lens interface.

Translational Relevance

Because the adhesiveness of contact lenses to ocular tissues may impact the comfort level for lens wearers and affect ease of removal, this study suggests that lens adhesion can be optimized through the control of crosslink density.

Hydrogels Based Drug Delivery Synthesis, Characterization and Administration

Hydrogels represent 3D polymeric networks specially designed for various medical applications. Due to their porous structure, they are able to swollen and to entrap large amounts of therapeutic agents and other molecules. In addition, their biocompatibility and biodegradability properties, together with a controlled release profile, make hydrogels a potential drug delivery system. In vivo studies have demonstrated their effectiveness as curing platforms for various diseases and affections. In addition, the results of the clinical trials are very encouraging and promising for the use of hydrogels as future target therapy strategies.

Synthesis and Characterization of Silicone Contact Lenses Based on TRIS-DMA-NVP-HEMA Hydrogels

In this study, silicone-based hydrogel contact lenses were prepared by the polymerization of 3-(methacryloyloxy)propyltris(trimethylsiloxy)silane (TRIS), N,N-dimethylacrylamide (DMA), 1-vinyl-2-pyrrolidinone (NVP), and 2-hydroxyethylmethacrylate (HEMA). The properties of silicone hydrogel lenses were analyzed based on the methods such as equilibrium water content, oxygen permeability, optical transparency, contact angle, mechanical test, protein adsorption, and cell toxicity. The results showed that the TRIS content in all formulations increased the oxygen permeability and decreased the equilibrium water content, while both DMA and NVP contributed the hydrophilicity of the hydrogels. The maximum value of oxygen permeability was 74.9 barrers, corresponding to an equilibrium water content of 44.5% as well as a contact angle of 82°. Moreover, L929 fibroblasts grew on all these hydrogels, suggesting non-cytotoxicity. In general, the silicone hydrogels in this work exhibited good oxygen permeability, stiffness, and optical transparency as well as anti-protein adsorption. Hence, these silicone hydrogel polymers would be feasible for making contact lens.

Impact of a Hyaluronic Acid-Grafted Layer on the Surface Properties of Model Silicone Hydrogel Contact Lenses

The introduction of high oxygen transmissibility silicone hydrogel lenses ameliorated hypoxia-related complications, making them the most prescribed type of contact lens (CL). Despite the progress made over the last 2 decades to improve their clinical performance, symptoms of ocular dryness and discomfort and a variety of adverse clinical events are still reported. Consequently, the rate of CL wear discontinuation has not been appreciably diminished by their introduction. Aiming to improve the interfacial interactions of silicone hydrogel CLs with the ocular surface, a biomimetic layer of hydrophilic glycosaminoglycan hyaluronic acid (HA) (100 kDa) was covalently attached to the surface of model poly(2-hydroxyethyl methacrylate- co-3-methacryloxypropyl-tris-(trimethylsiloxy)silane) (pHEMA- co-TRIS) silicone hydrogel materials via UV-induced thiol-ene "click" chemistry. The surface structural changes after each modification step were studied by Fourier transform infrared spectroscopy-attenuated total reflectance and X-ray photoelectron spectroscopy (XPS). Successful grafting of a homogeneous HA layer to the surface of the model silicone hydrogels was confirmed by the consistent appearance of N (1s) and the significant decrease of the Si (2p) peaks, as determined by low-resolution angle-resolved XPS. The HA-grafted surfaces demonstrated reduced contact angles, dehydration rate, and nonspecific deposition of lysozyme and albumin, while maintaining their optical transparency (>90%). In vitro studies demonstrated that the HA-grafted pHEMA- co-TRIS materials did not show any toxicity to human corneal epithelial cells. These results suggest that surface immobilization of HA via thiol-ene "click" chemistry can be used as a promising surface treatment for silicone hydrogel CLs.

Elemental Composition at Silicone Hydrogel Contact Lens Surfaces

OBJECTIVES

The outermost surface composition of 11 silicone hydrogel (SiHy) lenses was measured using X-ray photoelectron spectroscopy (XPS) to understand differences in wettability and potential interactions within an ocular environment. The SiHy lenses tested included balafilcon A, lotrafilcon A, lotrafilcon B, senofilcon A, comfilcon A, and somofilcon A reusable 2-week or monthly replacement lenses and delefilcon A, samfilcon A, narafilcon A, stenfilcon A, and somofilcon A daily disposable lenses.

METHODS

All lenses were soaked for 24 hr in phosphate-buffered saline to remove all packaging solution and dried under vacuum overnight before analysis. X-ray photoelectron spectroscopy measurements were performed at 2 take-off angles, 55° and 75°, to evaluate changes in elemental composition as a function of depth from the surface.

RESULTS

Detailed analysis of the XPS data revealed distinct differences in the chemical makeup of the different lens types. For all lenses, carbon, oxygen, and nitrogen were observed in varying quantities. In addition, fluorine was detected at the outermost surface region of comfilcon A (3.4%) and lotrafilcon A and B (<0.5%). The silicon content of the near-surface region analyzed varied among lens types, ranging from a low of 1.6% (lotrafilcon B) to a high of 16.5% (comfilcon A). In most instances, silicon enrichment at the outermost surface was observed, resulting from differences in lens formulation and design.

CONCLUSIONS

Lenses differed most in their surface silicon concentration, with lotrafilcon B and delefilcon A exhibiting the lowest silicon contents and comfilcon A lens exhibiting the highest. Silicon has hydrophobic properties, which, when found at the surface, may influence the wettability of the contact lenses and their interaction with the tear film and ocular tissues. Higher surface silicon contents have been previously correlated with adverse effects, such as enhanced lipid uptake, thus underscoring the importance of monitoring their presence.

Performance evaluation of delefilcon a water gradient daily disposable contact lenses in first-time contact lens wearers

PURPOSE

To evaluate the tolerability of and subject and investigator satisfaction with delefilcon A (DAILIES TOTAL1^®) daily disposable contact lenses in first-time contact lens wearers.

METHODS

This European multicenter, open-label, single-arm, two-week trial enrolled first-time contact lens wearers and fitted them with delefilcon A contact lenses. Assessments were made at dispensing and at Weeks 1 and 2. Subject-reported outcomes included comfort, quality of vision, convenience, and intent to purchase, which were ranked by agreement responses. Investigator-reported outcomes included slit-lamp biomicroscopy findings and lens fit satisfaction.

RESULTS

Ninety-two subjects were included in the per protocol dataset. Mean scores at Weeks 1 and 2 for subject-reported quality of vision and ocular comfort were significantly higher with delefilcon A contact lenses than with the subjects' habitual spectacles during the day, at the end of the day, and overall (all p ≤ 0.02). Ninety-one percent of subjects reported that their study lenses were more comfortable than expected, 98% agreed that they were convenient to use, and 92% were interested in purchasing the lenses (all p < 0.001). Investigators reported that study lenses had an acceptable fit in at least 97% of subjects.

CONCLUSIONS

Practitioners can expect favorable outcomes when transitioning first-time contact lens wearers from spectacles to delefilcon A daily disposable contact lenses.

Daily versus monthly disposable contact lens: Which is better for ocular surface physiology and comfort?

PURPOSE

To investigate the effect of soft contact lenses (SCL) wearing modality and lens materials on the changes in conjunctival bulbar and limbal redness and conjunctival and corneal staining after two months of SCL wear. Comfort level was also analyzed.

METHODS

In this longitudinal clinical trial, forty-seven neophyte myopic subjects were fitted with a monthly disposable lens (lotrafilcon-B or comfilcon-A or balafilcon-A) in one eye and a daily disposable lens (nelfilcon-A or stenofilcon-A or nesofilcon-A) in the other eye, randomly selected. Conjunctival bulbar and limbal redness and conjunctival and corneal staining were evaluated before and after lens wear. Effect of lens wearing modality and lens materials on these changes was also determined. Level of comfort was evaluated subjectively twice per day. Comfort level and reduction in end-of-day comfort were compared between different lens wearing modalities and materials.

RESULTS

Bulbar and limbal redness and conjunctival and corneal staining were increased (p<0.001) after lens wear, and changes were similar with daily and monthly disposable lens wear (p>0.05). Limbal redness was associated with lens materials, and lotrafilcon-B induced the least among the studied lenses (p<0.05). There was no significant association between the wearing modality and the average comfort level and reduction of end-of-day comfort (p>0.05).

CONCLUSION

Two months of SCL wear increased conjunctival redness, conjunctival and corneal staining, which were not associated with the lens wearing modality. There was a reduction in end-of-day comfort, similar to daily and monthly lenses. The change in limbal redness and reduction in end-of-day comfort were associated with the characteristics of the lens material.

Influence of Tear Protein Deposition on the Oxygen Permeability of Soft Contact Lenses

Purpose. To investigate the effect of tear protein deposition on the change in oxygen permeability (Dk) of soft contact lenses (SCL). Methods. Three hydrogel lenses (polymacon, nelfilcon A, and etafilcon A) and two silicon hydrogel lenses (lotrafilcon A and balafilcon A) were investigated. Etafilcon A lenses were incubated in artificial tear solution for 1, 6, 12, and 48 h, whereas the other SCL were incubated for 1, 3, 7, and 14 days. Oxygen permeability was measured using the polarographic method, and lenses were stacked in four layers to correct the boundary effect. Results. The Dk of all investigated SCL was decreased by the protein deposition. Silicone hydrogel lenses showed a smaller deposition of artificial tear proteins than conventional hydrogel lenses. However, their Dk was reduced twofold than those of 3 conventional hydrogel lenses when compared at the same level of protein deposition. Despite a large amount of total deposited protein in etafilcon A lenses, their Dk was more stable than other SCL. Conclusions. From the results, it was revealed that the Dk of SCL is different from the value provided by manufacturers because of the tear protein deposition on surface and/or in pore of SCL; however, the degree of Dk change in SCL was not simply correlated with the amount of tear protein deposition. Thus, it is considered that the correlation between tear protein deposition and properties of lens materials affects Dk change.

The effect of silicone hydrogel contact lens composition on dexamethasone release

The relationship between the delivery of dexamethasone and the composition of silicone hydrogel materials was investigated. Two hydrophilic monomers (2-hydroxyethyl methacrylate or N,N-dimethylacrylamide), a siloxy methacrylate-based monomer (1-(Bis(trimethylsiloxy)methylsilyl)propoxy-3-metacryloxy-2-propanol, a polysiloxane (monomethacryloxypropyl-terminated polydimethylsiloxane) and a polymerizable silicone surfactant (Silmer ACR A008-UP) were used to synthesize silicone hydrogels of variable composition. The materials properties, such as surface wettability and equilibrium water content, were highly dependent on polymer composition. All dexamethasone-loaded hydrogels showed uptake that was driven primarily by sorption to the polymer phase. Furthermore, a positive correlation between loading mass and equilibrium water content was established. The duration of drug release from the hydrogels ranged from one to greater than two weeks depending on the monomer composition and relative contribution of hydrophilic and hydrophobic monomers. Higuchi model rate constants for the release showed strong correlation with the equilibrium water content, signifying that the release is likely controlled by aqueous phase diffusion.