Preloaded and non-preloaded intraocular lens delivery system and characteristics: human and porcine eyes trial

AIM： To compare characteristics of preloaded and nonpreloaded intraocular lens（IOL） delivery systems during IOL delivery procedures. METHODS： Total 101 human eyes were included in this prospective observational case series. Delivery characteristics of 5 types of IOLs including i Sert250 NC60（NC60）, En Vista MX60（MX60）, Acry Sof IQ SN60 WF（SN60 WF）, TECNIS ZCB00（ZCB00）, and TECNIS PCB00（PCB00） were investigated. NC60 and PCB00 were injected via preloaded delivery systems and other IOLs were injected via nonpreloaded systems. In the human trial, time taken from IOL loading to completion of implantation was measured in all eyes undergoing conventional cataract surgery. Using 4 excised porcine eyes, dynamics of ophthalmic viscosurgical device（OVD） between an IOL injector and a porcine eye was analyzed using fluorescein sodiumstained OVD. RESULTS： The average time for IOL implantation was 22.0 s for NC60, 43.2 s for MX60, 32.3 s for SN60 WF, 41.4 s for ZCB00, and 14.6 s for PCB00 respectively. The number of cases with IOL manipulation with a second instrument was 6 for MX60, 2 for ZCB00, 0 for SN60 WF, NC60, and PCB00. Amount of OVD pushed into a porcine eye was smaller with a preloaded system than with non-preloaded systems. CONCLUSION： IOL delivery with preloaded systems is faster and more predictable. Moreover, a preloaded delivery system shows relatively less OVD pushed into a porcine eye than non-preloaded systems.

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.