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

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Abstract

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.

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Adapted from Adv. Drug Deliv. Rev., vol. 128, pp. 148–157, H. Kaji, N. Nagai, M. Nishizawa, and T. Abe, “Drug delivery devices for retinal diseases,” Copyright (2018) with permission from Elsevier [40]

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Abbreviations

MEMS:

Microelectromechanical systems

DME:

Diabetic macular edema

AMD:

Age-related macular degeneration

FBR:

Foreign body response

GDD:

Glaucoma drainage device

TF:

Tissue factor

PMN:

Polymorphonuclear leucocytes

ACAID:

Anterior chamber-associated immune deviation

ROS:

Reactive oxygen species

TLR:

Toll-like receptors

PRR:

Pattern recognition receptor

HMGB 1:

High mobility group box 1

MCP:

Monocyte chemotactic protein

MIP 1β:

Macrophage inflammatory protein 1β

DC:

Dendritic cells

CLs:

Contact lens

IPN or ipn:

Interpenetrating polymer networks

MPC:

2-Methacryloyloxyethyl phosphorylcholine

PMPC:

Poly(2-methacryloyloxyethyl) phosphorylcholine

PSiMA:

Poly(bis(trimethylsilyloxy)methylsilylpropyl glycerol methacrylate)

IOL:

Intraocular lens

ACO:

Anterior capsular opacification

PCO:

Posterior capsule opacification

FGF:

Fibroblast growth factor

LBL:

Layer by layer

ASC:

Anterior subcapsular cataract

MIGS:

Minimally invasive glaucoma surgery

TBO:

Trabeculoctomy

TBE:

Trabeculectomy

GFS:

Glaucoma filtration surgery

MMPC:

2-(Methacryloyloxy)ethyl-[N-(methacryloyloxy)ethyl phosphorylcholine

BSA:

Bovine serum albumin

FIH:

First in humans

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Funding

This work was supported by the National Research Foundation (NRF) of South Africa, South African Medical Research Council (SAMRC), and the University of the Witwatersrand, Johannesburg.

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  1. Wits Advanced Drug Delivery Platform Research Unit, Department of Pharmacy and Pharmacology, School of Therapeutic Sciences, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, 2193, South Africa

    Onyinye J. Uwaezuoke, Pradeep Kumar, Viness Pillay & Yahya E. Choonara

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  2. Pradeep Kumar
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O.J.U., P.K., V.P., and Y.E.C. planned the review; O.J.U. conducted the literature search and wrote the first draft; P.K., V.P., and Y.E.C. reviewed and revised the manuscript; all authors provided input to the reviewer comments and approved the final version.

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Correspondence to Yahya E. Choonara.

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Uwaezuoke, O.J., Kumar, P., Pillay, V. et al. Fouling in ocular devices: implications for drug delivery, bioactive surface immobilization, and biomaterial design. Drug Deliv. and Transl. Res. 11, 1903–1923 (2021). https://doi.org/10.1007/s13346-020-00879-1

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