The Intraocular Lens as a Drug Delivery Device: In Vitro Screening of Pharmacologic Substances for the Prophylaxis of Posterior Capsule Opacification

“…The scientific community is currently still in discourse on what is the appropriate amount of FCS for the capsular bag growth model. The used percentage varies widely from 0 to 10% across the literature and depends on the scientific requirements and the hypothesis [12,30]. The higher the concentration of FCS, the faster the PCO formation.…”

Section: Discussionmentioning

confidence: 99%

“…As the Clareon is a newly introduced IOL, there is little data on longterm incidence. To obtain an early assessment of PCO formation, the human capsular bag model is commonly used [12,13] to accelerate PCO formation ex vivo. Minor differences in PCO formation after implanting an IOL can be observed to test new IOL designs and types [14][15][16].…”

Section: Introductionmentioning

confidence: 99%

Evaluation of posterior capsule opacification of the Alcon Clareon IOL vs the Alcon Acrysof IOL using a human capsular bag model

et al. 2020

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Background: Posterior capsule opacification (PCO) after cataract surgery is influenced by intraocular lens (IOL) design and material. The following is an ex vivo comparison of PCO between the Clareon vs. the AcrySof IOL in human capsular bags. Methods: Twenty cadaver capsular bags from 10 human donors were used, with the novel hydrophobic IOL (Clareon, CNA0T0) being implanted in one eye and the other eye of the same donor receiving the AcrySof IOL (SN60WF) following phacoemulsification cataract surgery. Five capsular bags of 3 donors served as controls without IOL. Cellular growth of lens epithelial cells was photo-documented daily. The primary endpoint was the time until full coverage of the posterior capsule by cells. Furthermore, immunofluorescence staining of capsular bags for the fibrotic markers f-actin, fibronectin, alpha smooth muscle actin, and collagen type 1 were performed. Results: The new Clareon IOL did not show any disadvantages in terms of days until full cell coverage of the posterior capsule in comparison to the AcrySof (p > 0.99). Both, the Clareon (p = 0.01, 14.8 days) and the AcrySof IOL (p = 0.005, 15.7 days) showed a slower PCO development in comparison to the control (8.6 days). The fibrotic markers f-actin, fibronectin, alpha smooth muscle actin, and collagen type 1 were equally distributed between the two IOLs and differed from the control. Conclusions: A comparable performance has been found in the ex vivo formation of PCO between the two IOLs. Long-term clinical studies are necessary to reach final conclusions.

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“…In the case of PCO, the scope for drug delivery is greater. Cataract surgery is invasive, and drugs can be applied directly to the lens cells during surgery using closed drug delivery systems 48,49 or through modification of the IOL or a tension ring, [50][51][52] and these options will be explored in the future.…”

Section: Discussionmentioning

confidence: 99%

Resveratrol Inhibits Wound Healing and Lens Fibrosis: A Putative Candidate for Posterior Capsule Opacification Prevention

Smith

Eldred

Wormstone

2019

Invest. Ophthalmol. Vis. Sci.

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PURPOSE. Posterior capsule opacification (PCO) is a common complication of cataract surgery. In addition to improved surgical methods and IOL designs, it is likely additional agents will be needed to improve patient outcomes. Presently no pharmacological agent is in clinical use to prevent PCO. Here we investigate the putative ability of resveratrol (RESV), a naturally occurring polyphenol, as a therapeutic agent. METHODS. The human lens epithelial cell line FHL124, a human lens capsular bag model, and central anterior epithelium were used as experimental systems. Standard culture was in 5% fetal calf serum Eagle's minimum essential medium; 10 ng/mL transforming growth factor-b2 (TGFb2) was used to induce fibrotic changes. A scratch wound assay was used to measure cell migration and the patch assay was used to assess matrix contraction by FHL124 cells. Protein expression was assessed by immunocytochemistry and Western blot and gene expression by quantitative RT-PCR. In capsular bags, cell growth across the posterior lens capsule, capsular wrinkling, and epithelial-to-mesenchymal transition were determined by image analysis. RESULTS. In FHL124 cells, addition of 30 lM RESV significantly impeded cell migration in a wound-healing assay. RESV significantly inhibited TGFb2-induced expression of the myofibroblast marker alpha-smooth muscle actin (a-SMA) at both the message and protein levels, as well as significantly inhibiting matrix contraction induced by TGFb2. In human capsular bags, 30 lM RESV significantly inhibited cell growth. TGFb2-induced a-SMA expression and capsular wrinkling were also significantly inhibited by RESV treatment. RESV significantly suppressed expression of TGFb2-induced genes associated with fibrotic disease, including matrix metalloproteinase-2 in FHL124 cells, capsular bags, and central anterior epithelium. CONCLUSIONS. RESV can counter PCO-related physiological events in two human lens model systems. RESV therefore has the potential to be used as a candidate agent for the prevention of PCO, which in turn could benefit millions of cataract patients.

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The Intraocular Lens as a Drug Delivery Device: In Vitro Screening of Pharmacologic Substances for the Prophylaxis of Posterior Capsule Opacification

Abstract: We could identify caffeic acid phenethyl ester and methotrexate in vitro as potential candidates for IOL modification for PCO prophylaxis.

Cited by 30 publications

References 52 publications

The intraocular lens as a drug delivery device for an epidermal growth factor–Receptor inhibitor for prophylaxis of posterior capsule opacification

The intraocular lens as a drug delivery device for an epidermal growth factor–Receptor inhibitor for prophylaxis of posterior capsule opacification

Evaluation of posterior capsule opacification of the Alcon Clareon IOL vs the Alcon Acrysof IOL using a human capsular bag model

Resveratrol Inhibits Wound Healing and Lens Fibrosis: A Putative Candidate for Posterior Capsule Opacification Prevention

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