Eye Drops Research Articles

Outcomes of Phacoemulsification With or Without Kahook Dual Blade Goniotomy for Glaucoma Patients with Cataract.

This meta-analysis examines the comparative efficacy of phacoemulsification with and without Kahook Dual Blade Goniotomy in individuals with glaucoma and cataract, aiming to elucidate optimal surgical approaches for coexisting conditions. The purpose of this current study is to compare the effect of combining Kahook Dual Blade (KDB) goniotomy with phacoemulsification versus phacoemulsification alone on intraocular pressure (IOP) and medication reduction in patients with glaucoma and cataract. We conducted a systematic review and meta-analysis utilizing computer databases, including Embase (OVID), MEDLINE (OVID and PubMed), CINHAL (EBSCO), and the Cochrane Library (Wiley). We included studies examining the IOP-lowering effect of KDB goniotomy combined with phacoemulsification and studies that examined the IOP-lowering effect of phacoemulsification alone in patients with open angle glaucoma or ocular hypertension. The mean reduction of IOP and the reduction in topical glaucoma eye drops after surgery were determined. A total of 26 studies were included reporting on 1659 patients, 684 patients underwent phacoemulsification alone and 975 underwent combined phacoemulsification and KDB goniotomy. A 9.62% IOP reduction from baseline occurred following phacoemulsification as a solo procedure compared to 22.74% following combined KDB goniotomy with phacoemulsification. Similarly, the combination of the procedures caused a significant drop in the mean number of glaucoma eye drops used (mean reduction=1.35, 95% CI [1.08, 1.61]) compared to phacoemulsification alone (mean reduction=0.36, 95% CI [0.06, 0.66]). Funnel plots suggested the absence of publication bias. Both phacoemulsification alone or combined with KDB goniotomy result in a significant decrease in post-op IOP and topical glaucoma eye drops. The combination of these two procedures outperforms phacoemulsification alone in terms of both parameters.

Combination of PEGylation and Cationization on Phospholipid-Coated Cyclosporine Nanosuspensions for Enhanced Ocular Drug Delivery.

Strong precorneal clearance mechanisms including reflex blink, constant tear drainage, and rapid mucus turnover constitute great challenges for eye drops for effective drug delivery to the ocular epithelium. In this study, cyclosporine A (CsA) for the treatment of dry eye disease (DED) was selected as the model drug. Two strategies, PEGylation for mucus penetration and cationization for potent cellular uptake, were combined to construct a novel CsA nanosuspension (NS@lipid-PEG/CKC) by coating nanoscale drug particles with a mixture of lipids, DSPE-PEG2000, and a cationic surfactant, cetalkonium chloride (CKC). NS@lipid-PEG/CKC with the mean size ∼173 nm and positive zeta potential ∼+40 mV showed promoted mucus penetration, good cytocompatibility, more cellular uptake, and prolonged precorneal retention without obvious ocular irritation. More importantly, NS@lipid-PEG/CKC recovered tear production and goblet cell density more efficiently than the commercial cationic nanoemulsion on a dry eye disease rat model. All results indicated that a combination of PEGylation and cationization might provide a promising strategy to coordinate mucus penetration and cellular uptake for enhanced drug delivery to the ocular epithelium for nanomedicine-based eye drops.

Topical insulin in neurotrophic keratopathy after diabetic vitrectomy

To assess the efficacy and safety of topical insulin (TI) for treating neurotrophic keratopathy (NK) within one-month post-diabetic vitrectomy (DV) compared to conventional non-invasive measures, we conducted this retrospective case-control study including all eyes that developed acute NK (stages 2 and 3) following DV between October 2020 and June 2023. The control group included NK cases managed with preservative-free lubricant eye drops and prophylactic topical antibiotics. In contrast, the study group included NK cases treated with TI [1 unit per drop] four times daily, in addition to the previously mentioned treatment. The primary outcome measure was time to epithelial healing. Secondary outcome measures included any adverse effect of TI or the need for amniotic membrane transplantation (AMT). During the study period, 19 patients with a mean age of 49.3 ± 8.6 years received TI versus 18 controls with a mean age of 52.5 ± 10.7 years. Corneal epithelial healing was significantly faster in the TI-treated group compared to controls, with a mean difference of 12.16 days (95% CI 6.1–18.3, P = 0.001). Survival analysis indicated that the insulin-treated group had 0% and 20% of NK stages 2 and 3, respectively, that failed to achieve corneal epithelial healing, compared to 20% and 66.7% for the control group (P < 0.001). In the control group, two eyes required AMT due to progressive thinning. Additionally, three patients in the control group, progressing to stage 3 NK, were switched to TI, achieving healing after a mean of 14 days. No adverse effects were reported in the TI-treated group. Our study suggests that TI can effectively and safely promote the healing of NK after DV.

Comparison of the recovery characteristics for canine corneal ulcer treated with corneoconjunctival transposition or conjunctival autografts

Corneal ulceration induced by Staphylococcus pseudintermedius (S. pseudintermedius) is a common clinical eye disease. Antibiotics combined with corneoconjunctival transposition (CCT) or conjunctival autografts (CA) are often used, but the recovery characteristics are still unknown. In this experiment, canine corneal ulcer models induced by S. pseudintermedius and treated with levofloxacin eye drops (LED) were created. The models were used to compare the recovery characteristics of CCT and CA, combined with LED, by clinical observation, histopathology, and cytokine expression detected by qRT-PCR analysis. The results showed that the ulcerative cornea with only LED treatment perforated after 48 h. The mRNA expression of TLR2, IL-1β, IL-6, IL-8, and TNF-α genes was significantly elevated on 14, 28, and 35 days after the surgery compared to normal (p < 0.01). On day 42, the inflammatory damage had resolved, but the corneal transparency and arrangement of collagen fibrils in the CCT group were higher than those in the CA group. The mRNA expression of EGF, FGF, TGF-β1 and VEGF genes increased significantly (p < 0.01), mostly until day 42, proving that CCT and CA surgery contributed to the corneal recovery, and relieved the inflammatory reaction, with the elimination of corneal cicatrices needing a period of reconstruction. Therefore, this study has provided, for the first time, the method for establishing a canine corneal ulcer model induced by S. pseudintermedius. More importantly, the recovery of canine ulcerative corneas with CCT or CA surgery is reported for the first time.

An antibiotic efficacy comparative study between market-prescribed and solid-lipid fluoroquinolone ophthalmic nanoformulation against conjunctivitis

Besifloxacin hydrochloride (BSF) drug substance (DS), is effective against gram-positive and gram-negative microorganisms. BSF (liquid suspension form) is already available in two different market brands: Besivance and Besix. Both of these commercialized drug products (DP) have lower mucoadhesive characteristics, therefore they spend less time in contact with various ocular tissues (cornea and conjunctiva). This research work emphasized the design, development, and optimization of BSF-loaded solid-lipid nanoparticles (BSF@SLN) to increase antibacterial activity by enhancing drug absorption through passive diffusion techniques in the ocular organ compared to conventional dosage forms. The SLN was prepared through a very simple process hot homogenization process using glyceryl monostearate and polysorbate-80 along with poloxamer-188 and water for injection. Various characterization techniques like FTIR, DSC, and XRD were performed to check the compatibility between DS and excipients. The preliminary formulation of SLN was characterized through zeta potential, polydispersity index, and particle size techniques. The developed SLN was optimized following 32 factorial designs. Surface morphology and size of optimized BSF@SLN ophthalmic DP were confirmed by using advanced microscopic techniques such as SEM. In-vitro release of optimized BSF@SLN ophthalmic DP was performed by using two chambers of Franz diffusion cell. Stability studies of optimized BSF@SLN ophthalmic nanoformulations were tested for up to 6 months at 25°C ± 2°C/60% ± 5% RH. The antimicrobial activity of optimized ophthalmic nanoformulation was found 2.76 times more effective compared to the Besix eye drop. In-vivo study of BSF@SLN ophthalmic nanoformulations was carried out with an eye irritancy test and compared with marketed DP (Besix). and found significant pharmacological.

РАЗРАБОТКА СОСТАВА И ТЕХНОЛОГИИ ГЛАЗНЫХ КАПЕЛЬ АНЕСТЕЗИРУЮЩЕГО ДЕЙСТВИЯ

In modern ophthalmological practice, the use of local anesthetics for surface anesthesia of the eyeball becomes an integral stage in preparing the patient for diagnostic studies, therapeutic manipulations, surgical and laser interventions. The share of regional pain management methods is steadily increasing. However, at the same time, the list of requirements that local anesthetics must meet is also growing. According to them, the drug that combines high anesthetic activity and minimal toxicity should be considered the best. The local anesthetic anilocaine hydrochloride, developed according to the author's method in PGFA, exhibits high surface anesthetic activity with relatively low toxicity, and also has anti-inflammatory and moderate antimicrobial activity, which distinguishes it very favorably from the local anesthetics used and is an alternative to the use of expensive imported drugs. The purpose of this study is to develop the composition and technology of anesthetic eye drops. Materials and methods. The pharmaceutical substance anilocaine hydrochloride was used as a pharmacologically active component. The determination of the hydrogen index was carried out by the potentiometric method in accordance with the requirements of the OFS "Ionometry". To study the stability of eye drops, characterized by the indicator "Related impurities", a high-pressure liquid chromatograph "ShimadzuLCProminence" (Japan) was used. Statistical processing of the results of chemical studies was carried out according to generally accepted methods using standard EXCEL computer programs. Results and discussion. As a result of the conducted research, the composition of anesthetic eye drops based on anilocaine hydrochloride has been substantiated and developed. A technology for manufacturing eye drops has been developed to ensure the sterility of the resulting form. Conclusion. Based on technological and microbiological studies, the composition and technology of locally anesthetic eye drops based on anilocaine hydrochloride for surface (drip) anesthesia of the eyeball has been developed.

Normal-Tension Glaucoma Complicated by a Giant Internal Carotid-Ophthalmic Artery Aneurysm

Purpose. We describe a patient with normal tension glaucoma (NTG) of several years whose management was complicated by the presence of a giant internal carotid-ophthalmic artery aneurysm. Observations. A 72-year-old woman presented to our glaucoma clinic with accelerated deterioration of her vision in her left eye (OS) over a 1-month period. Her ophthalmic history was most notable for bilateral NTG diagnosed 3 years prior which had been treated with several laser trabeculoplasty OS and topical bimatoprost 0.01% eye drops in both eyes (OU). Upon evaluation, her visual acuity OS had worsened, and visual field (VF) testing showed extensive progressive losses temporally and pericentrally OS over a year with stable IOP measurements and no neurological complaints. Given her atypical NTG progression, she was referred for an urgent neurological evaluation which revealed an unruptured giant left internal carotid-ophthalmic aneurysm. Following the successful treatment of the aneurysm with platinum coils, she continued to demonstrate additional bilateral ophthalmic changes including further progression of VF loss and RNFL thinning OS&gt;OD on follow-up. Conclusion and Importance. Overall, this report describes a unique complication in the management of a patient with chronic bilateral NTG in the form of a giant internal carotid-ophthalmic aneurysm. Moreover, it highlights the need for clinicians to maintain a degree of suspicion for compressive lesions of the optic nerve when presented with atypical progression of VFs and/or visual acuity loss in glaucomatous patients.

Glaucoma (Eye Disease) and its Associated Diagnosis and Treatment Process: A Schematic Concise Review

A class of eye conditions known as glaucoma can result in blindness and visual loss by harming the optic nerve, a nerve located at the back of the eye. You might not notice the symptoms at first because they can appear so slowly. A thorough dilated eye exam is the only way to determine if you have glaucoma. While there is no known cure for glaucoma, vision protection and damage can frequently be stopped with early intervention. Primary open-angle and angle-closure glaucoma, as well as secondary open and angle-closure glaucoma, are the four main types of adult glaucoma. Prescription eye drops are the most popular form of treatment for glaucoma. They function by reducing intraocular pressure and shielding your optic nerve from harm. Although these eye drops cannot reverse vision loss or treat glaucoma, they can prevent glaucoma from worsening. Prostaglandins are one type of prescription eye drop medication. By increasing the fluid's outflow from your eye, they aid in lowering intraocular pressure. Latanoprost (Xalatan), Travoprost (Travatan Z), Tafluprost (Zioptan), Bimatoprost (Lumigan), and Latanoprostene bunod (Vyzulta) are among the medications in this category. Alpha-adrenergic agonists, such as brimonidine (Altagan P) or Qoliana (Iopidine, apraclonidine) Beta-blockers such as Betimol, Istalol, Timoptic (timolol), and Betoptic (betaxolol) Inhibitors of carbonic anhydrases, such as Azopt (brinzolamide) and Trusopt (dorzolamide). In this review study, we discuss the aetiology, epidemiology, current management, and pathophysiology of glaucoma.

Incorporation of Inclusion Complexes in the Dissolvable Microneedle Ocular Patch System for the Efficiency of Fluconazole in the Therapy of Fungal Keratitis.

Fluconazole (FNL) is one of the first-line treatments for fungal keratitis as it is an effective broad-spectrum antimicrobial commonly administered orally or topically. However, FNL has a very low water solubility, limiting its drug formulation, therapeutic application, and bioavailability through tissues. To overcome these limitations, this study aimed to develop FNL inclusion complexes (FNL-IC) with cyclodextrin (α-cyclodextrin, sulfobutylether-β-cyclodextrin, and hydroxypropyl-γ cyclodextrin) and incorporate it into a dissolvable microneedle (DMN) system to improve solubility and drug penetration. FNL-IC was evaluated for saturation solubility, Fourier transform infrared spectroscopy, differential scanning calorimetry, in vitro release, minimum inhibitory concentration, minimum fungicidal concentration, and time-killing assay. DMN-FNL-IC was evaluated for mechanical and insertion properties, surface pH, moisture absorption ability, water vapor transmission, and drug content recovery. Moreover, ocular kinetic, ex vivo antimicrobial, in vivo antifungal, and chorioallantoic membrane (HET-CAM) assays were conducted to assess the overall performance of the formulation. Mechanical strength and insertion properties revealed that DMN-FNL-IC has great mechanical and insertion properties. The in vitro release of FNL-IC was significantly improved, exhibiting a 9-fold increase compared to pure FNL. The ex vivo antifungal activity showed significant inhibition of Candida albicans from 6.54 to 0.73 log cfu/mL or 100-0.94%. In vivo numbers of colonies of 0.87 ± 0.13 log cfu/mL (F2), 4.76 ± 0.26 log cfu/mL (FNL eye drops), 3.89 ± 0.24 log cfu/mL (FNL ointments), and 8.04 ± 0.58 log cfu/mL (control) showed the effectiveness of DMN preparations against other standard commercial preparations. The HET-CAM assay showed that DMN-FNL-IC (F2) did not show any vascular damage. Finally, a combination of FNL-IC and DMN was developed appropriately for ocular delivery of FNL, which was safe and increased the effectiveness of treatments for fungal keratitis.

Codetermination of antimicrobial agents in rabbit tear fluid using LC-MS/MS assay: Insights into ocular pharmacokinetic study.

Managing ocular microbial infections typically requires pharmacotherapy using antibiotic eye drops, such as moxifloxacin hydrochloride (MFX), combined with an antifungal agent like amphotericin B (AB). We carried out and validated an LC-MS/MS assay to quantify these compounds in rabbit tear fluid in order to look into the pharmacokinetics of these two drugs. We employed a protein precipitation technique for the extraction of drugs under examination. A Waters Symmetry C18 column was used to separate the analytes and internal standard. The composition of the mobile phase was like (A) 0.1% v/v formic acid in water and (B) methanol. The detection of MFX and AB was accomplished through the utilization of positive ion electrospray ionization under multiple reaction monitoring mode. The linearity curves for both analytes exhibited an acceptable trendline across a concentration range of 2.34-300 ng/mL for MFX and 7.81-1000 ng/mL for AB in surrogate rabbit tear fluid. The lower limit of quantitation for MFX was 2.34 ng/mL, while for AB, it was 7.81 ng/mL. The approach was strictly validated, encompassing tests of selectivity, linearity (with r2>0.99), precision, accuracy, matrix effects, and stability. Consequently, we employed this method to evaluate the pharmacokinetics profiles of MFX and AB in rabbit tear fluid following single topical doses.

Dual-ROS-scavenging and dual-lingering nanozyme-based eye drops alleviate dry eye disease

Efficiently removing excess reactive oxygen species (ROS) generated by various factors on the ocular surface is a promising strategy for preventing the development of dry eye disease (DED). The currently available eye drops for DED treatment are palliative, short-lived and frequently administered due to the short precorneal residence time. Here, we developed nanozyme-based eye drops for DED by exploiting borate-mediated dynamic covalent complexation between n-FeZIF-8 nanozymes (n-Z(Fe)) and poly(vinyl alcohol) (PVA) to overcome these problems. The resultant formulation (PBnZ), which has dual-ROS scavenging abilities and prolonged corneal retention can effectively reduce oxidative stress, thereby providing an excellent preventive effect to alleviate DED. In vitro and in vivo experiments revealed that PBnZ could eliminate excess ROS through both its multienzyme-like activity and the ROS-scavenging activity of borate bonds. The positively charged nanozyme-based eye drops displayed a longer precorneal residence time due to physical adhesion and the dynamic borate bonds between phenyboronic acid and PVA or o-diol with mucin. The in vivo results showed that eye drops could effectively alleviate DED. These dual-function PBnZ nanozyme-based eye drops can provide insights into the development of novel treatment strategies for DED and other ROS-mediated inflammatory diseases and a rationale for the application of nanomaterials in clinical settings.Graphical

Novel disposable screen-printed sensors based on copper oxide nanoparticles for sensitive voltammetric assay of antazoline

The fabrication and electroanalytical validation of a novel homemade screen-printed carbon electrode enriched with copper oxide nanoparticles (CuONPs/SPCEs) were demonstrated for sensitive and selective voltammetric determination antazoline (ANT) in eye drop solution and spiked serum samples. With a reported electrocatalytic activity, CuONPs catalyzed the oxidation of ANT at the electrode surface showing an irreversible anodic oxidation peak at 0.9 V under a diffusion-controlled electrode reaction. Based on the electroanalytical and molecular orbital calculation studies, oxidation of ANT molecule undergoes via oxidation of the aliphatic nitrogen atom within the ANT moiety. Linear calibration curves were illustrated covering the ANT concentration ranged from 0.01 to 3.819 µg mL−1 with and limit of detection 3 ng mL−1. The fabricated sensors enriched with CuONPs exhibited high fabrication and measurement reproducibility with a prolonged shelf lifetime (6 months). The electroanalytical approach presented adequate sensitivity and selectivity with a short analysis time, applying low-cost instrumentation and simple pretreatment protocol avoiding handling hazardous organic solvents. Trace ANT was monitored in the presence of different interfering species, degradation products, and xylometazoline hydrochloride (ZYL) in the co-formulated ophthalmic pharmaceutical samples. The CuONPs based voltammetric sensors were introduced as a reliable eco-friendly analytical tool for monitoring ANT in ophthalmic solutions and biological fluids with acceptable recovery values.

Effects of a Long-Acting Diquafosol Ophthalmic Solution on the Ocular Surface, Tolerability, and Usability in Dry Eye Disease.

This study aimed to investigate the tolerability of high-viscosity diquafosol tetrasodium (DQS) ophthalmic solution (DIQUAS LX; DQSLX) and examine its usability and effect on clinical findings in patients with dry eye disease (DED). This interventional retrospective study included 66 eyes of 66 patients with DED who switched from conventional DQS to DQSLX ophthalmic solution. Tear function assessments (tear film breakup time [BUT], keratoconjunctival vital staining [VS] score), evaluations of DED symptom relief, and a four-item usability questionnaire ("comfort upon instillation," "irritation upon instillation," "eye mucus discharge," "convenience of instillation frequency") assessed using a visual analog scale from 0 (worst) to 10 (best) were administered 4weeks after switching to DQSLX. Factors associated with drug tolerability were assessed using multiple regression analysis. The symptoms improved by 64.2% after switching to DQSLX. The BUT value, VS score, and the questionnaire items "comfort upon instillation" and "convenience of instillation frequency" were significantly improved after switching to DQSLX. DQSLX tolerability was reported as acceptable in 56 (84.8%) and unacceptable in 10 (15.2%) patients. Overall, DQSLX tolerability was significantly associated with "comfort upon instillation" and "convenience of instillation frequency" and tended to be associated with a VS score ≥ 1. DQSLX tolerability depended on symptom and VS score improvements and absence of excessive "eye mucus discharge" in patients with a VS score ≥ 1 (39 patients), but on "comfort upon instillation" and absence of excessive "eye mucus discharge" in patients with a VS score = 0 (27 patients). The high-viscosity DQSLX ophthalmic solution was generally considered acceptable in the study population. However, drug tolerability seemingly differed between patients with DED with and without epithelial damage. The former were affected by improvements in symptoms and clinical findings, whereas the latter were affected by comfort upon instillation. University Hospital Medical Information Network identifier, UMIN000051390.

Ocular Pharmacology.

Treatment of ocular diseases presents unique challenges and opportunities for the clinician and for the clinical pharmacologist. Ophthalmic pharmaceuticals, typically given as liquids, require consideration of solubility, physiological pH, and osmolarity, as well as sterility and stability, which in turn requires optimal pharmaceutics. Ocular tissue levels are challenging to obtain in humans, and the clinical pharmacokinetics is typically blood levels, which are primarily related to safety, rather than efficacy. The eye is a closed compartment with multiple physiological barriers with esterases and transporters, but relatively little cytochrome oxidases. Delivery routes include topical, intravitreal, and systemic. Patient dosing involves not only adherence issues common to all chronic diseases, but also performance requirements on eye drop instillation. Therapeutically, ocular diseases and their pharmacological treatments include both those analogous to systemic diseases (e.g., inflammation, infection, and neuronal degeneration) and those unique to the eye (e.g., cataract and myopia).

Test-Retest of the Spot Vision Screener among Children with Ophthalmological Diseases including Strabismus.

The spot vision screener (SVS) has been widely used for eye health examinations of infants and young children. The purpose of this study was to evaluate the reproducibility of two SVS measurements in children with ophthalmological diseases. 29 patients aged 15 years or younger who visited our hospital for refraction examinations with SVS before and at least 60 minutes after administration of 2 drops of 1% cyclopentolate ophthalmic solution (before and after cycloplegia) were included in this study. Two SVS measurements were made before and after cycloplegia, respectively. Intraclass correlation coefficients (ICCs) and Bland-Altman analysis for spherical, spherical equivalent (SE), cylindrical, J0, and J45 values before and after cycloplegia were analyzed. The mean age ± standard deviation (SD) of the 29 patients was 7.6 ± 2.4 years. There were 11 males and 18 females. The mean spherical values based on the SVS before and after cycloplegia were 0.42 ± 1.67 diopter (D), and 1.47 ± 2.23 D for the first measurement and 0.60 ± 1.74 D, and 1.42 ± 2.27 D for the second measurement, respectively. The mean cylindrical values based on SVS before and after cycloplegia were -1.45 ± 0.96 D and -1.65 ± 0.89 D for the first measurement and -1.58 ± 1.13 D and -1.66 ± 0.91 D for the second measurement, respectively. The ICCs for the first and second spherical, SE, cylindrical, J0, and J45 values before cycloplegia were 0.95, 0.98, 0.83, 0.86, and 0.86, respectively. The ICCs for the first and second spherical, SE, cylindrical, J0, and J45 values after cycloplegia were 0.99, 0.99, 0,87, 0.73, and 0.80, respectively. The Bland-Altman analysis of the first and second spherical and SE values before cycloplegia showed fan-shaped variation as hyperopia increased. Two consecutive SVS refraction measurements have a high degree of reproducibility for spherical and SE values but a low degree for cylindrical, J0, and J45 values. From these results, multiple measurements are required to obtain reliable results for cylindrical values.

Development of a biodegradable polymer-based implant to release dual drugs for post-operative management of cataract surgery.

Cataract surgery is followed by post-operative eye drops for a duration of 4-6 weeks. The multitude of ocular barriers, coupled with the discomfort experienced by both the patient and their relatives in frequently administering eye drops, significantly undermines patient compliance, ultimately impeding the recovery of the patient. This study aimed to design and develop an ocular drug delivery system as an effort to achieve a drop-free post-operative care after cataract surgery. An implant was prepared containing a biodegradable polymer Poly-lactic-co-glycolic acid (PLGA), Dexamethasone (DEX) as an anti-inflammatory drug, and Moxifloxacin(MOX) as an antibiotic. Implant characterization and drug loading analysis were conducted. In vitro drug release profile showed that the release of the two drugs are correlated with the clinical prescription for post operative eye drops. In vivo study was conducted on New Zealand albino rabbits where one eye underwent cataract surgery, and the drug delivery implant was inserted into the capsular bag after placement of the synthetic intraocular lens (IOL). Borderline increase in the intraocular pressure (IOP) was noted in the test sample group. Slit-lamp observations revealed no significant anterior chamber reaction in all study groups. Histopathology study of the operated eye revealed no significant pathology in the test samples. This work aims at developing the intra ocular drug delivery implant which will replace the post-operative eye drops and help the patient with the post-operative hassle of eye drops.

A mechanical device for precise self-administration of ocular drugs

Individuals with glaucoma are routinely prescribed and required to self-administer eye drop-based medication multiple times a day. Unfortunately, the process of self-administering eye drops requires a level of dexterity, strength, and visual acuity that the elderly population often do not possess, resulting in poor adherence and worsening condition. In this paper, we detail a prototyped eye drop assist device designed to safely and reliably deliver prescription medications. The ergonomic device safely anchors the eye drop bottle tip an optimal distance away from the face, aligns to the pupil, and provides feedback to the user when their head is at an appropriate tilt for a successful eye drop administration. We experimentally verify that the device improves hand steadiness, provides accurate head tilt feedback, precisely positions the bottle tip, and predictably delivers eye drops into the eye according to a parameterized model.

Ultrasmall copper nanodots eye drops for microenvironment regulation of diabetes retinopathy by relieving hypoxia and inhibiting HIF-1α/VEGF signaling pathway

Diabetic retinopathy (DR) is the main cause of visual loss among blinding diseases. The pathological microenvironment, characterized by hypoxia, reactive oxygen species (ROS) accumulation and oxidative stress, is critical to the onset and progression of DR. In this study, an ultrasmall (4–6 nm) copper nanodots was developed as nanozyme (Cu NZs) and dispersed in 2 % Methocel to formulate Cu NZs eye drops to relieve hypoxia and scavenge excrescent ROS for the effective treatment of DR. Due to its smaller size and higher specific surface area, Cu NZs exposes more active sites and can guarantee excellent antioxidant activity. The results of in vitro studies indicated that Cu NZs had biocompatible and protective effects on human retinal microvascular endothelial cells (HRMECs), alleviating hypoxia in HRMECs, reducing oxidative stress, and inhibiting hypoxia-inducing factor-1α (HIF-1α)/ vascular endotheliogenesis factor (VEGF) signaling pathway. In an animal model of streptozotocin (STZ)-induced DR, Cu NZs eye drops have been shown to greatly relieve the hypoxic microenvironment of DR and inhibit the expression of HIF-1α and VEGF. CuNZs eye drops reduced inflammatory factors in the DR microenvironment, significantly reducing the progression of neovascularization and vascular leakage. And the nano-enzyme eye drops have no toxic side effects on the eyes and important organs of the whole body. This treatment mode based on the nano enzyme cascade reaction from comprehensive microenvironment regulation (hypoxia relief, free radical scavenging, anti-inflammatory), has excellent ability to treat DR. Although the nanoparticle is effective against DR in the short term at the cellular and animal levels, the long-term efficacy and safety remains to be evaluated.

Remote-controlled dexamethasone-duration on eye-surface with a micelle-magnetic nanoparticulate co-delivery system for dry eye disease

Dexamethasone (DEX) is used to treat ocular surface diseases. However, regulating DEX duration in tears while preventing its absorption into the anterior chamber is critical for balancing its therapy effects and the side effects. In this study, a novel magnetic nanoparticle (MNP)-micelle (MC) co-delivery system (MMDS) was developed. The MC moiety in the MMDS served as the carrier for DEX and the MNP part endowed the MMDS with magnetic-responsive properties. To extend its residency, the MMDS was magnetically attracted by an external magnet after instilling, which acted as a precorneal drug-depot enabling a sustainable release of DEX in tears. With combination of magnet treatment, the topical instillation of MMDS@DEX significantly prolonged the DEX-retention in tears and increased the DEX-concentration in the cornea and conjunctiva, as well as concurrently reduced the DEX-level in the aqueous humor, when compared with the commercial DEX eye drop treatment. The combination of MMDS@DEX and magnet treatment exerted significantly better therapeutic effects against DED with smaller side effects than conventional treatments including DEX suspension, commercial DEX eye drops, as well as the MMDS@DEX treatment alone. The present work provided a new method for the effective delivery of DEX to ocular surface tissues while reducing its side effects, which will be beneficial to the treatments of a wide range of ocular surface diseases.

Dry eye syndrome associated with traumatic keratitis

Dry eye syndrome (DES) is an urgent problem in healthcare practice worldwide. Various diseases of the eye are of particular importance for the development of this syndrome. A special place among the diseases leading to symptomatic DES with ocular surface lesion belongs to corneal injuries of traumatic origin. The frequency of post-traumatic complications of the eye, especially the cornea, remains high due to its anatomical location. And often these patients are at risk of secondary DES. For the pathogenesis of DES after ke­ratitis, ultrastructural changes in the cells of different corneal layers and the toxic effect on the tear film layers of preservative-containing drugs used in the treatment of keratitis are important. The purpose of the study was to assess the severity of secondary DES in patients after traumatic keratitis and the effectiveness of hyaluronic acid combined with antioxidants in the treatment of this pathology. An ophthalmological examination, functional tests were made, and the Ocular Surface Disease Index was used to evaluate the symptoms and severity of the disease. The criteria for the effectiveness of the therapy with hyaluronic acid in combination with vitamins A and E four times a day were: reduction of corneal syndrome, increase in the tear film break-up time, a decrease in subjective discomfort. Clinical observation of patients with DES after traumatic keratitis showed that the use of hyaluronic acid can result in a significant reduction or complete disappearance of subjective symptoms of the disease, sustained improvement in vision and increased stability of the tear film. The use of these eye drops makes it possible to reach compliance and shorten the treatment period.