Abstract

SummaryNanotechnology solves the main obstacles in topical drug delivery. Nanotechnology provides increased solubility of lipophilic molecules in tear fluid and sustained release for several hours.Cyclodextrin nanoparticles containing dexamethasone increase solubility of dexamethasone in tear fluid 30 fold and the drug stays in tear film for 6 hours compared with minutes for conventional eye drops. The high concentration gradient from tear film into eye wall creates a flux which is active for many hours following eye drop application. This delivers approximately 10 times more drug into the eye and reaches the posterior segment in significant concentration. At the same time relatively less drug is absorbed systemically.Several clinical trials have demonstrated the efficacy of the cyclodextrin nanoparticle platform both for posterior and anterior segment use.Two clinical trials in 41 patients have shown significant improvement in visual acuity and retinal structure in diabetic macular edema. Two reports show compelling effect on intermediate/posterior uveitis with cystoid macular edema. Once a day treatment following cataract surgery is effective and the dexamethasone nanoparticle eye drops can replace mitomycin C in trabeculectomy.

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