Abstract
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.
Highlights
Biocompatibility of intraocular lens (IOL) is critical to vision reconstruction after cataract surgery
Many studies have demonstrated that hydrophilic surface can reduce protein adsorption and cell adhesion, and surface modifications of hydrophobic acrylic IOL have been attempted to increase biocompatibility without changing the bulk properties14–17. 2-methacryloyloxyethyl phosphorylcholine (MPC, Supplementary Fig. S1a) is a zwitterionic molecule and shows excellent biocompatibility since it can form a membrane-like structure and trap water molecules on the material surface, suppressing protein adsorption and cell adhesion[14,18,19,20]
These results demonstrated that the P(MPC-MAA) copolymer was successfully synthesized
Summary
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. 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. Capsular biocompatibility refers to the interaction between the IOL and LECs. Once the lens is removed, remnant LECs in the capsule can attach to the IOL surface, and proliferate, migrate and differentiate into fibroblast-like cells, causing ACO and PCO8,11. Once the lens is removed, remnant LECs in the capsule can attach to the IOL surface, and proliferate, migrate and differentiate into fibroblast-like cells, causing ACO and PCO8,11 Inflammatory cells such as macrophages and monocytes secrete growth factors and cytokines that may aggravate capsule opacification[12]. Uveal and capsular biocompatibility of MPC-modified hydrophobic acrylic IOL has not been evaluated in vivo
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