Abstract
Posterior Capsular Opacification (PCO) is the capsule fibrosis developed on implanted IntraOcular Lens (IOL) by the de-differentiation of Lens Epithelial Cells (LECs) undergoing Epithelial Mesenchymal Transition (EMT). Literature has shown that the incidence of PCO is multifactorial including the patient's age or disease, surgical technique, and IOL design and material. Reports comparing hydrophilic and hydrophobic acrylic IOLs have shown that the former has more severe PCO. On the other hand, we have previously demonstrated that the adhesion of LECs is favored on hydrophobic compared to hydrophilic materials. By combining these two facts and contemporary knowledge in PCO development via the EMT pathway, we propose a biomimetically inspired strategy to promote LEC adhesion without de-differentiation to reduce the risk of PCO development. By surface grafting of a cell adhesion molecule (RGD peptide) onto the conventional hydrophilic acrylic IOL material, the surface-functionalized IOL can be used to reconstitute a capsule-LEC-IOL sandwich structure, which has been considered to prevent PCO formation in literature. Our results show that the innovative biomaterial improves LEC adhesion, while also exhibiting similar optical (light transmittance, optical bench) and mechanical (haptic compression force, IOL injection force) properties compared to the starting material. In addition, compared to the hydrophobic IOL material, our bioactive biomaterial exhibits similar abilities in LEC adhesion, morphology maintenance, and EMT biomarker expression, which is the crucial pathway to induce PCO. The in vitro assays suggest that this biomaterial has the potential to reduce the risk factor of PCO development.
Highlights
Cataract is the opacity of the crystalline lens or capsule of the eye, causing impairment of vision or even blindness
The tissue culture grade polystyrene (TCPS) stands for Tissue Culture PolyStyrene surface optimized for cell culture and serves as a reference for lens epithelial cells (LECs) proliferation and morphology
We propose a potential solution by functionalizing the surface of a conventional hydrophilic acrylic IntraOcular Lens (IOL) material with the RGD peptide sequence to promote LEC adhesion
Summary
Cataract is the opacity of the crystalline lens or capsule of the eye, causing impairment of vision or even blindness. Posterior Capsular Opacification (PCO), is the most common postoperative complication of cataract surgery. PCO involves the clouding of the posterior capsule by the lens epithelial cells (LECs), forming a thick layer on the IOL and causing loss of vision again. Nd:YAG laser capsulotomy has been used to treat PCO by creating a hole in the clouded lens capsule to allow light to pass to the retina. This method potentially creates other complications such as damage to the IOL, higher intraocular pressure, cystoid macular edema, and retinal detachment [1, 6]. The problem of PCO has been a challenge to scientists and ophthalmologists for decades
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