A novel gatifloxacin-loaded intraocular lens for prophylaxis of postoperative endophthalmitis

Postoperative endophthalmitis(POE)has been the most threatening complication after cataract surgery,which perhaps can be solved by the antibiotic-loaded intraocular lens(IOL).However,most drug-loaded IOLs demonstrate insufficient drug quantity,short release time,increased implantation-related difficulties or other noticeable drawbacks.To prevent POE and to address these deficiencies,a drug-loaded copolymer IOL,prepared from poly(urethane acrylate)prepolymer,isobornyl methacrylate(IBOMA),N-vinyl-2-pyrrolidone(NVP),Irgacure 819,RUVA-93,and gatifloxacin(GAT),was rapidly fabricated via photocuring and by using a 3D-printed mold.This composite displayed an outstanding and controllable GAT release behavior in vitro,a high light transmittance,and a moderate refractive index.Also,it demonstrated improved strain stress and elongation compared with the reference commercial acrylic IOL material.In vivo tests demonstrated satisfying released drug concentration at the early treatment stage.In vitro and in vivo studies further confirmed the remarkable bacterial inhibition and prevention of POE by the proposed IOL,which also displayed good biocompatibility.These findings suggested that the GAT-loaded IOL could be a promising implant to prevent and cure POE,also the proposed methods could inspire more designs for various medical applications.

Prophylaxis of posterior capsule opacification through autophagy activation with indomethacin-eluting intraocular lens

Posterior capsule opacification(PCO)is the most common long-term postoperative complication of cataract surgery,leading to secondary vision loss.Optimized intraocular lens(IOL)structure and appropriate pharmacological intervention,which provides physical barriers and biological inhibition,respectively,can block the migration,proliferation,and epithelial-mesenchymal transition(EMT)of lens epithelial cells(LECs)for PCO prophylaxis.Herein,a novel indomethacin-eluting IOL(INDOM-IOL)with an optimized sharper edge and a sustained drug release behavior was developed for PCO prevention.Indomethacin(INDOM),an ophthalmic non-steroidal anti-inflammatory drug(NSAID)used for postoperative ocular inflammation,was demonstrated to not only be able to suppress cell migration and down-regulate the expression of cyclooxygenase-2(COX-2)and EMT markers,including alpha-smooth muscle actin(α-SMA)and cyclin D1,but also promote the autophagy activation in LECs.Additionally,autophagy was also verified to be a potential therapeutic target for the down-regulation of EMT in LECs.The novel IOL,serving as a drug delivery platform,could carry an adjustable dose of hydrophobic indomethacin with sustained drug release ability for more than 28 days.In the rabbit PCO model,the indomethacin-eluting IOL showed excellent anti-inflammatory and anti-PCO effects.In summary,indomethacin is an effective pharmacological intervention in PCO prophylaxis,and the novel IOL we developed prevented PCO in vivo under its sustained indomethacin release property,which provided a promising approach for PCO prophylaxis in clinical application.

Clinically applicable artificial intelligence algorithm for the diagnosis,evaluation,and monitoring of acute retinal necrosis

The prompt detection and proper evaluation of necrotic retinal region are especially important for the diagnosis and treatment of acute retinal necrosis(ARN).The potential application of artificial intelligence(AI)algorithms in these areas of clinical research has not been reported previously.The present study aims to create a computational algorithm for the automated detection and evaluation of retinal necrosis from retinal fundus photographs.A total of 149 wide-angle fundus photographs from40 eyes of 32 ARN patients were collected,and the U-Net method was used to construct the AI algorithm.Thereby,a novel algorithm based on deep machine learning in detection and evaluation of retinal necrosis was constructed for the first time.This algorithm had an area under the receiver operating curve of 0.92,with 86%sensitivity and 88%specificity in the detection of retinal necrosis.For the purpose of retinal necrosis evaluation,necrotic areas calculated by the AI algorithm were significantly positively correlated with viral load in aqueous humor samples(R2=0.7444,P<0.0001)and therapeutic response of ARN(R2=0.999,P<0.0001).Therefore,our AI algorithm has a potential application in the clinical aided diagnosis of ARN,evaluation of ARN severity,and treatment response monitoring.