Variations in electrophoretic tear protein pattern due to contact lens wear

Powering smart contact lenses for continuous health monitoring: Recent advancements and future challenges

As the tear is noninvasively and continuously available, it has been turned into a convenient biological interface as a wearable medical device for out-of-hospital and self-monitoring applications. Recent progress in integrated circuits (ICs) and biosensors coupled with wireless data communication techniques have led to the implementation of smart contact lenses that can continuously sample tear fluid, analyze physiological conditions, and wirelessly transmit data to an electronic device such as smartphone, which can send data to relevant healthcare units. Continuous analyte monitoring is one of the significant characteristics of wearable biosensors. However, despite several advantages over other on-skin wearable medical devices, batteries cannot be incorporated on smart contact lenses for continuous electrical power supply due to the limited area. Herein, we review the progress of power delivery techniques of smart contact lenses for the first time. Different approaches, including wireless power transmission (WPT), biofuel cells, supercapacitors, flexible batteries, wired connections, and hybrid methods, are thoroughly discussed to understand the principles of self-sustainable contact lens biosensors comprehensively. Additionally, recent progress in contact lens biosensors is reviewed in detail, thereby providing the prospects for further developments of smart contact lenses as a common biosensing platform for various disease monitoring and diagnostic applications.

Effect of Intense Pulsed Light Therapy on Tear Proteins and Lipids in Meibomian Gland Dysfunction

PURPOSE

To assess the effect of a novel intense pulsed light (IPL) therapy on tear proteins and lipids in eyes with Meibomian gland dysfunction (MGD).

METHODS

Twenty-four eyes of 12 patients with MGD were recruited and received five overlapping flashes (565-1400 nm) directed at the lower eyelid. The IPL parameters include intensity: 2.5 to 6.5 J/cm2, voltage: 100 to 240 V, frequency: 50 to 60 Hz, input: 16 W, maximum optical energy: 23 J, pulse duration: <2.0 ms, and repetition time: 1-3.5 s. Tear samples were evaluated immediately before and 2 weeks after IPL therapy and included measurements of protein concentration, electrophoretic mobility by using sodium dodecyl sulfate-polyacrylamide gel electrophoresis, lipid profile assessments, and thin-layer chromatography (TLC) for phospholipids.

RESULTS

Significant improvements were observed in tear protein concentrations and molecular weight after IPL therapy. The most pronounced effect was in the molecular weight of tear lysozyme, lactoferrin, and albumin. Tear lipids showed an improvement in the concentrations of total lipids, triglycerides, cholesterol, and phospholipids. On TLC, the tears in patients with MGD had significantly lower amounts of anionic phosphatidylethanolamine, phosphatidylinositol, and phosphatidylserine but amounts zwitterionic neutral phospholipid phosphatidylcholine were normal. These anionic phospholipids showed obvious recovery after IPL therapy.

CONCLUSION

IPL therapy is effective in eyes with MGD. It improved tear protein and lipid content and composition. The anionic phospholipids were more responsive to IPL therapy than were the other zwitterionic phospholipids.

Effect of Ramadan Fasting on Tear Proteins

Muslims abstain from eating, drinking and smoking from dawn to sunset during the holy month of Ramadan. Prolonged fasting is thought to be among risk factors for many diseases, e.g., cardiovascular, gastrointestinal and various infectious diseases. It could also play a part in several eye diseases, including dry eye syndrome, glaucoma, and cataract. Toxic and oxidative effects due to increased concentrations of some biochemicals as a result of reduction in tear volume thought to play an important role in damaging ocular tissue. Human tear is an important biological fluid similar to blood in many aspects. Tear film is composed of three basic layers i.e. lipid, aqueous and mucin. The tear film covering the ocular surface presents a mechanical and antimicrobial barrier, and endures an optical refractive surface. The aim of this study was to analyze and compare tear protein of volunteers during fasting. Using two reliable analytical methods, i.e. electrophoresis and high performance liquid chromatography (HPLC), we compared tear protein content of sixty volunteers (35 males and 25 females, 23–27 years old) during fasting in holly month of Ramadan (FAST: n=62) and one month before Ramadan (CTRL: n=60). The results showed that some identified tear proteins decreased during fasting. On the other hand, the activity of some enzymes such as lysozyme, lactoferrin and alpha amylase also decreased in fasting samples. Electrophoresis results showed that tear protein patterns in FAST (P<0.05) were different from those of CTRL. There were a few more protein peaks in the FAST group (P<0.005) than in CTRL.

Antimicrobial compounds in tears

The tear film coats the cornea and conjunctiva and serves several important functions. It provides lubrication, prevents drying of the ocular surface epithelia, helps provide a smooth surface for refracting light, supplies oxygen and is an important component of the innate defense system of the eye providing protection against a range of potential pathogens. This review describes both classic antimicrobial compounds found in tears such as lysozyme and some more recently identified such as members of the cationic antimicrobial peptide family and surfactant protein-D as well as potential new candidate molecules that may contribute to antimicrobial protection. As is readily evident from the literature review herein, tears, like all mucosal fluids, contain a plethora of molecules with known antimicrobial effects. That all of these are active in vivo is debatable as many are present in low concentrations, may be influenced by other tear components such as the ionic environment, and antimicrobial action may be only one of several activities ascribed to the molecule. However, there are many studies showing synergistic/additive interactions between several of the tear antimicrobials and it is highly likely that cooperativity between molecules is the primary way tears are able to afford significant antimicrobial protection to the ocular surface in vivo. In addition to effects on pathogen growth and survival some tear components prevent epithelial cell invasion and promote the epithelial expression of innate defense molecules. Given the protective role of tears a number of scenarios can be envisaged that may affect the amount and/or activity of tear antimicrobials and hence compromise tear immunity. Two such situations, dry eye disease and contact lens wear, are discussed here.

Tear lipids interfacial rheology: effect of lysozyme and lens care solutions

PURPOSE

To evaluate the interfacial properties of ex vivo tear lipid multilayers with controlled and varying thickness. The influence of lysozyme and surfactant-containing multipurpose lens care solution (MPS) on interfacial rheology of lipids and mixed lipid-protein films were studied.

METHODS

Lipids were extracted from lotrafilcon A lenses worn continuously for 1 month. Interfacial properties of the lipids without and with lysozyme in the aqueous phase were examined using tensiometry and step-strain relaxation. Lipid-lysozyme multilayers were exposed to either diluted opti-free express (OFX) or opti-free replenish (OFR) for 30 min, and then MPS was displaced from the bulk phase. Surface tension and rheological parameters before and after MPS exposure were measured and compared.

RESULTS

Thick lipid films exerted high surface pressure at the air-aqueous interface, 50 +/- 2 mN/m, with little inter- and intrasubject variability. The rheological storage modulus (E(infinity); 25.3 +/- 2 mN/m) and relaxation time (tau; 87 +/- 25 s) were similar among subjects. Neither lysozyme nor MPS changed the surface tension of the lipid multilayers. Lysozyme adsorbed irreversibly onto multilayers without changing E(infinity), but increased tau 2.5 times. Exposure of mixed multilayers to OFX reduced E(infinity) to less than a half of its original value (13 +/- 4.5 mN/m; p < 0.001), whereas after OFR exposure, small but statistically significant changes in E(infinity) were found (21 +/- 3.0 mN/m; p = 0.0044). MPS-treated mixed films relaxed much slower than an untreated one, tau increased 4.5 times after OFX and 7 times after OFR exposure.

CONCLUSIONS

Thick multilayers of the ex vivo tear lipids have exhibited surface tension 15 +/- 1 mN/m lower than reported in the literature for meibomian lipids. The lipid-lysozyme interaction altered the interfacial rheology of the ex vivo lipids. OFX and OFR changed rheological properties of the mixed films to different extents.