Surface Gel Layers Reduce Shear Stress and Damage of Corneal Epithelial Cells

Abstract

Soft contact lenses are medical devices made from aqueous polymeric gels that are worn on the eye to correct refractive errors. These devices interrupt the natural contact pairing between the cornea and the eyelid and create two interfaces comprised of a synthetic material and the epithelia—contact lens surfaces versus (1) the cornea and (2) the eyelid conjunctiva. The cellular responses to friction and shear stress are thought to contribute to contact lens discomfort. This study performs direct contact shear experiments using in vitro biotribological experiments using a microtribometer equipped with a hydrogel membrane probe. Sections from commercial contact lenses are held in place on a spherically capped membrane probe during reciprocating sliding experiments against confluent monolayers of living human telomerase-immortalized corneal epithelial cells (hTCEpi). The contact lenses were loaded against the cell monolayers to physiological contact pressures between 400 and 1300 Pa under an applied load of 200 µN. The reciprocating distance was 3 mm, at a sliding speed of 1 mm/s, and the maximum duration of sliding was 1000 cycles. Five commercially available lenses (somofilcon A, stenfilcon A, etafilcon A, verofilcon A, and delefilcon A) were used to evaluate the cell layer responses to aqueous gels of differing composition, surface modulus, and lubricity. Cell damage was measured via propidium iodide staining and in situ fluorescence microscopy. The shear stresses varied from 16 ± 2 Pa (delefilcon A and verofilcon A) to 86 ± 12 Pa (stenfilcon A), and cell damage increased with increasing shear stress and increasing sliding duration. The two lens materials that have high water content surface gel layers (delefilcon A and verofilcon A) showed distinctly lower measures of cell damage as compared to the other lenses. Surface gel layers with a large polymer mesh size and high water content are shown to be an effective approach to lower the contact pressure, lower the friction coefficient, and thereby lower the shear stress and cell damage.