Drug loading of foldable commercial intraocular lenses using supercritical impregnation

Supercritical CO2 impregnation process applied to polymer samples preparation for dynamic nuclear polarization solid-state NMR

In this study, supercritical CO₂ (scCO₂ ) was used to impregnate polymers with paramagnetic polarizing agents to prepare samples for dynamic nuclear polarization (DNP) solid-state NMR (ssNMR) experiments. As a proof of concept, we impregnated polystyrene samples with bTbK, which stands for bis-TEMPO-bisketal where TEMPO is 2,2,6,6-tetra-methylpiperindin-1-oxyl. Substantial DNP signal enhancements could be measured on DNP-enhanced ¹ H → ¹³ C cross-polarization (CP) magic-angle spinning (MAS) spectra recorded at 9.4 T and ~100 K, reaching a maximum value of 8 in the most favorable case, which appeared comparable or even higher than what is typically obtained on similar systems for former sample preparation methods. These results highlight the potential of scCO₂ impregnation as an efficient and possibly versatile methodology to prepare polymer samples for DNP ssNMR investigations.

Advances in ophthalmic drug delivery technology for postoperative management after cataract surgery

INTRODUCTION

Cataract surgery is becoming more common due to an aging world population. Intraocular lenses and surgical technique have developed remarkably recently, but the development of postoperative medication to prevent postsurgery complications has been relatively delayed. We still largely depend on eye drops for the management of post-cataract-surgery patients. Mental and physical problems that often occur in elderly cataract patients make it difficult for patients to apply eye drops by themselves. It is necessary to develop new effective drug delivery methods.

AREAS COVERED

This updated review article provides a brief review of why drug management is needed following cataract surgery and an overview of current developments in new drug delivery methods for ophthalmic treatment. In particular, various novel drug delivery methods that can be used for post-cataract-surgery management and their current development stages are extensively reviewed.

EXPERT OPINION

Rapidly developing technologies, such as intraocular and external ophthalmic implants, polymers, and nanotechnology, are being actively applied to develop novel drug delivery systems for safe and effective management after cataract surgery. Their goal is to achieve sufficient drug release for the desired duration with a single application. These will largely replace the inconvenience of eye drops for elderly patients in the future.

Drug Carriers: A Review on the Most Used Mathematical Models for Drug Release

Carriers are protective transporters of drugs to target cells, facilitating therapy under each points of view, such as fast healing, reducing infective phenomena, and curing illnesses while avoiding side effects. Over the last 60 years, several scientists have studied drug carrier properties, trying to adapt them to the release environment. Drug/Carrier interaction phenomena have been deeply studied, and the release kinetics have been modeled according to the occurring phenomena involved in the system. It is not easy to define models’ advantages and disadvantages, since each of them may fit in a specific situation, considering material interactions, diffusion and erosion phenomena, and, no less important, the behavior of receiving medium. This work represents a critical review on main mathematical models concerning their dependency on physical, chemical, empirical, or semi-empirical variables. A quantitative representation of release profiles has been shown for the most representative models. A final critical comment on the applicability of these models has been presented at the end. A mathematical approach to this topic may help students and researchers approach the wide panorama of models that exist in literature and have been optimized over time. This models list could be of practical inspiration for the development of researchers’ own new models or for the application of proper modifications, with the introduction of new variable dependency.

An overview on the application of supercritical carbon dioxide for the processing of pharmaceuticals

Supercritical carbon dioxide (scCO2) application in the pharmaceutical industry is still undeveloped regardless of significant research interests in this processing medium shown in the last decades. ScCO2 technologies can improve drug solubility, bioavailability, and therapeutic effect. These technologies can lead to the development of new formulations that will contribute to a decrease in drug dose, medication frequency, and increase patients' well-being. Considering the significant decrease in the price of high-pressure equipment and society's growing need for cleaner production and safer products, it is expected that symbiosis between supercritical fluid and pharmaceutical technologies will happen soon. Therefore, this review was focused on the latest contributions of scCO2 technologies to the pharmaceutical field. The main aim was to bring these technologies closer to pharmaceutical specialists. For this purpose, the most commonly used technologies were explained and discussed: the preparation of solid dispersions, polymer impregnation with drugs, and drug micro/nanoparticle production using scCO2.

Mass Transfer and Optical Properties of Active PET/PP Food-Grade Films Impregnated with Olive Leaf Extract

A supercritical solvent impregnation (SSI) technique was employed to incorporate, by batch- and semicontinuous-modes, bioactive olive leaf extract (OLE) into a food-grade multilayer polyethylene terephthalate/polypropylene (PET/PP) film for active food packaging applications. The inclusion of OLE in the polymer surfaces significantly modified the colour properties of the film. A correlation of 87.06% between the CIELAB colour parameters and the amount of the OLE impregnated in the film was obtained which suggests that colour determination can be used as a rapid, non-destructive technique to estimate the OLE loading in the impregnated matrices. The UV barrier and water permeability properties of the films were not significantly modified by the incorporation of OLE. The migration of OLE into a 50% (v/v) ethanol food simulant demonstrated faster release of OLE from the PP surface than from the PET surface which may be due to the different interactions between OLE and each polymer.

Intraocular lenses as drug delivery devices

Cataract surgery is one of the most common and safe surgical procedures nowadays. However, it is not free of risks as endophthalmitis, ocular inflammation and posterior capsule opacification (PCO) can appear as post-surgery complications. The usual eye drop therapy used as prophylaxis for the former two complications has limited bioavailability. In turn, the prevention of PCO involves an adequate surgical technique and a careful choice of intraocular lens (IOL) design and material. Also, different drugs have been tested to reduce incidence of PCO, but no prophylaxis demonstrated to be completely effective. In the past few years, IOLs have been proposed as drug delivery devices to replace or/assist the usual eye drop therapy in the post-operatory period. The great advantage of drug loaded IOLs would be to ensure a continuous drug delivery, independent of patient's compliance without requiring any further action besides IOL implantation. The biggest challenge of drug loaded IOLs production is to achieve a controlled and extended release that meet therapeutic needs without inducing toxicity to the surrounding ocular tissues or affecting the physical properties of the lens. This review starts by addressing the possible complications after cataract surgery, as well as the most commonly adopted prophylaxis for each of them. The various types of IOLs are described and their main advantages/disadvantages are discussed. The different strategies pursued to incorporate drugs into the IOLs and control their release, which include soaking the IOL in the drugs solution, supercritical impregnation, surface modifications, and attachment of drug reservoirs to the IOL, among others, are reported. For each strategy, a summary of the publications is presented, which includes the target complication, the types and amounts of released drugs and the IOL materials. A brief description of each individual study is given afterwards. Optimization of drug loaded IOLs through mathematical modelling and possible issues raised by their sterilization are also tackled. At the end, the future commercialization of drug loaded IOLs is commented.

Contact Lenses as Ophthalmic Drug Delivery Systems: A Review

Ophthalmic drugs used for the treatment of various ocular diseases are commonly administered by eye drops. However, due to anatomical and physiological factors, there is a low bioavailability of the active principle. In order to increase the drug residence time on the cornea to adequate levels, therapeutic contact lenses have recently been proposed. The polymeric support that constitutes the contact lens is loaded with the drug; in this way, there is a direct and effective pharmacological action on the target organ, promoting a prolonged release of the active principle. The incorporation of ophthalmic drugs into contact lenses can be performed by different techniques; nowadays, the soaking method is mainly employed. To improve the therapeutic performance of drug-loaded contact lenses, innovative methods have recently been proposed, including the impregnation with supercritical carbon dioxide. This updated review of therapeutic contact lenses production and application provides useful information on the most effective preparation methodologies, recent achievements and future perspectives.

Therapeutic Ophthalmic Lenses: A Review

An increasing incidence of eye diseases has been registered in the last decades in developed countries due to the ageing of population, changes in lifestyle, environmental factors, and the presence of concomitant medical conditions. The increase of public awareness on ocular conditions leads to an early diagnosis and treatment, as well as an increased demand for more effective and minimally invasive solutions for the treatment of both the anterior and posterior segments of the eye. Despite being the most common route of ophthalmic drug administration, eye drops are associated with compliance issues, drug wastage by lacrimation, and low bioavailability due to the ocular barriers. In order to overcome these problems, the design of drug-eluting ophthalmic lenses constitutes a non-invasive and patient-friendly approach for the sustained drug delivery to the eye. Several examples of therapeutic contact lenses and intraocular lenses have been developed, by means of different strategies of drug loading, leading to promising results. This review aims to report the recent advances in the development of therapeutic ophthalmic lenses for the treatment and/or prophylaxis of eye pathologies (i.e., glaucoma, cataract, corneal diseases, or posterior segment diseases) and it gives an overview of the future perspectives and challenges in the field.

A Critical Appraisal of New Developments in Intraocular Lens Modifications and Drug Delivery Systems for the Prevention of Cataract Surgery Complications

Cataract surgery is the commonest ophthalmic surgery worldwide. The replacement of the diseased lens with a synthetic one (intraocular lens-IOL) remains the treatment of choice, despite its potential complications that include infection, inflammation and posterior capsule opacification. The potential for drug delivery via the IOL has been researched extensively over a period of twenty-five years, yet there is very limited progress in transferring the findings from research to everyday practice. The objective of this review is to assess the progress made in the field of IOL lens modifications and drug delivery systems over the past five years. Thirty-six studies that were conducted during the past five years were identified and deemed suitable for inclusion. They were grouped in three broad categories, studies that described new methods for loading a drug onto the IOL, assessment of the effects of drugs that were loaded to the IOL and studies that assessed the effects of non-pharmaceutical modifications of IOLs. While considerable progress is continually being made with regard to methods and materials, there is still little capitalization upon these research studies, with no commercially available IOL-based drug delivery system being available. Close cooperation between researchers in basic sciences (chemistry, physics, materials science and pharmacy), clinical researchers, IOL manufacturers and the pharmaceutical industry is an important prerequisite for further development.

Multi-region finite element modelling of drug release from hydrogel based ophthalmic lenses

Understanding the way in which drug is released from drug carrying hydrogel based ophthalmic lenses aids in the development of efficient ophthalmic drug delivery. Various solute-polymer interactions affect solute diffusion within hydrogels as well as hydrogel-bulk partitioning. Additionally, surface modifications or coatings may add to resistance of mass transfer across the hydrogel interface. It is necessary to consider both interfacial resistances as well as the appropriate driving force when characterizing interface flux. Such a driving force is induced by a difference in concentration which deviates from equilibrium conditions. We present a Galerkin finite element approach for solute transport in hydrogels which accounts for diffusion within the gel, storage effects due to polymer-solute interaction, as well as partitioning and mass transfer resistance effects at the interface. The approach is formulated using a rotational symmetric model to account for realistic geometry. We show that although the resulting global system is not symmetric in the case of partitioning, it is similar to a symmetric negative semidefinite system. Thus, it has non-positive real eigenvalues and is coercive, ensuring the validity of the finite element formulation as well as the numerical stability of the implicit backward Euler time integration method employed. Two models demonstrating this approach are presented and verified with release experimental data. The first is the release of moxifloxacin from intraocular lenses (IOLs) plasma grafted with different polyacrylates. The second accounts for both loading as well as the release of diclofenac from disc shaped IOL material loaded for varied time periods and temperature.

Posterior capsule opacification: What's in the bag?

Cataract, a clouding of the lens, is the most common cause of blindness in the world. It has a marked impact on the wellbeing and productivity of individuals and has a major economic impact on healthcare providers. The only means of treating cataract is by surgical intervention. A modern cataract operation generates a capsular bag, which comprises a proportion of the anterior capsule and the entire posterior capsule. The bag remains in situ, partitions the aqueous and vitreous humours, and in the majority of cases, houses an intraocular lens (IOL). The production of a capsular bag following surgery permits a free passage of light along the visual axis through the transparent intraocular lens and thin acellular posterior capsule. Lens epithelial cells, however, remain attached to the anterior capsule, and in response to surgical trauma initiate a wound-healing response that ultimately leads to light scatter and a reduction in visual quality known as posterior capsule opacification (PCO). There are two commonly-described forms of PCO: fibrotic and regenerative. Fibrotic PCO follows classically defined fibrotic processes, namely hyperproliferation, matrix contraction, matrix deposition and epithelial cell trans-differentiation to a myofibroblast phenotype. Regenerative PCO is defined by lens fibre cell differentiation events that give rise to Soemmerring's ring and Elschnig's pearls and becomes evident at a later stage than the fibrotic form. Both fibrotic and regenerative forms of PCO contribute to a reduction in visual quality in patients. This review will highlight the wealth of tools available for PCO research, provide insight into our current knowledge of PCO and discuss putative management of PCO from IOL design to pharmacological interventions.

Implantable Medical Devices and Tissue Engineering: An Overview of Manufacturing Processes and the Use of Polymeric Matrices for Manufacturing and Coating their Surfaces

Medical devices are important diagnosis and therapy tools for several diseases which include a wide range of products. Technological advances in this area have been proposed to reduce adverse complication incidences. New technologies and manufacturing processes, as well as the development of new materials or medical devices with modified surface and the use of biodegradable polymeric devices such as a substrate for cell culture in the field of tissue engineering, have attracted considerable attention in recent years by the scientific community intended to produce medical devices with superior properties and morphology. This review article focused on implantable devices, addresses the major advances in the biomedical field related to the devices manufacture processes such as 3D printing and hot melting extrusion, and the use of polymer matrices composed of copolymers, blends, nanocomposites or grafted with antiproliferative drugs for manufacturing and/or coating the devices surface.

Impregnation of mesoporous silica with poor aqueous soluble molecule using pressurized carbon dioxide: Is the solubility in the supercritical and subcritical phase a critical parameter?

Recently, mesoporous silica (MS) has been used as a material able to maintain amorphous state of active compounds and therefore, enhance the oral bioavailability of BCSII drugs. Among impregnation methods of MS, techniques using supercritical carbon dioxide (Sc-CO₂) are promising tools. Solubility of compounds in Sc-CO₂ is reported as one of the most critical parameters, which usually limits its use in drug formulation. Indeed, most of compounds have poor solubility in Sc-CO₂. The aim of this work is to compare different MS and to study alternative processes using pressurized CO₂ for insoluble molecule in Sc-CO₂. By using high pressure reactor, DSC, HPLC and in vitro dissolution tests, the crystallinity and dissolution profiles of MS with different pore size (6.6 nm, 25.0 nm and 2.5 nm) impregnated with fenofibrate (FF) under Sc-CO₂ were compared to select the most appropriate carrier. Then, the selected MS has been impregnated under supercritical, subcritical and atmospheric conditions. We have shown that the MS pore size of 6.6 nm provides the higher amorphous drug loading capacity as well as the faster and higher drug dissolution. In addition, FF-MS formulations produced with pressurized CO₂ as fusion medium, both in subcritical and supercritical conditions; give similar crystallinity and dissolution results compared to those produced with supercritical fluids as solvent. Through this study, we show new possibilities of using CO₂ for insoluble compounds in this fluid.

Supercritical fluid technology for the development of innovative ophthalmic medical devices: Drug loaded intraocular lenses to mitigate posterior capsule opacification

Supercritical impregnation technology was applied to load acrylic intraocular lenses (IOLs) with methotrexate to produce a sustained drug delivery device to mitigate posterior capsule opacification. Drug release kinetics were studied in vitro and used to determine the drug loading. Loaded IOLs and control IOLs treated under the same operating conditions, but without drug, were implanted ex vivo in human donor capsular bags. The typical cell growth was observed and immunofluorescence staining of three common fibrosis markers, fibronectin, F-actin and α-smooth muscle actin was carried out. Transparent IOLs presenting a sustained release of methotrexate for more than 80 days were produced. Drug loading varying between 0.43 and 0.75 ± 0.03 µg_drug·mg^-1_IOL were obtained when varying the supercritical impregnation pressure (8 and 25 MPa) and duration (30 and 240 min) at 308 K. The use of ethanol (5 mol%) as a co-solvent did not influence the impregnation efficiency and was even unfavorable at certain conditions. Even if the implantation of methotrexate loaded IOLs did not lead to a statistically significant variation in the duration required for a full cell coverage of the posterior capsule in the human capsular bag model, it was shown to reduce fibrosis by inhibiting epithelial-mesenchymal transformation. The innovative application presented has the potential to gain clinical relevance.

Magnetically targeted co-delivery of hydrophilic and hydrophobic drugs with hollow mesoporous ferrite nanoparticles

A magnetically targeted drug delivery system (DDS) is developed to solve the delivery problem of hydrophobic drugs by using hollow mesoporous ferrite nanoparticles (HMFNs). The HMFNs are synthesized by a one-pot hydrothermal method based on the Ostwald ripening process. The biocompatibility of the synthesized HMFNs was determined by MTT assay, lactate dehydrogenase (LDH) leakage assay and hemolyticity against rabbit red blood cells. Moreover, Prussian blue staining and bio-TEM observations showed that the cell uptake of nanocarriers was in a dose and time-dependent manner, and the nanoparticles accumulate mostly in the cytoplasm. A typical highly hydrophobic anti-tuberculosis drug, rifampin (RFP) was loaded into HMFNs using supercritical carbon dioxide (SC-CO₂) impregnation, and the drug loading amount reached as high as 18.25 wt%. In addition, HMFNs could co-encapsulate and co-deliver hydrophobic (RFP) and hydrophilic (isoniazide, INH) drugs simultaneously. The in vitro release tests demonstrated extra sustained co-release profiles of rifampicin and isoniazide from HMFNs. Based on this novel design strategy, the co-delivery of drugs in the same carrier enables a drug delivery system with efficient enhanced chemotherapeutic effect.

A magnetically targeted drug delivery system (DDS) is developed to solve the delivery problem of hydrophobic drugs by using hollow mesoporous ferrite nanoparticles (HMFNs).

Intra-ocular lens optical changes resulting from the loading of dexamethasone

To study the optical changes on hydrogel-silicone intraocular lenses (IOLs) resulting from loading them with dexamethasone. We used prototype hydrogel(pHEMA)-silicone IOLs and loaded the matrices with an anti-inflammatory drug (dexamethasone). The optical properties we analyzed experimentally were a) modulation transfer function (MTF); b) spectral transmission; c) diopter power. These determinations were performed on drug-loaded IOLs, IOLs that had released the drug, and IOLs that had not been drug-loaded. Loading a hydrogel-silicone IOL with dexamethasone results in impairment of its optical qualities, in particular its MTF and spectral transmission, but not dioptric power. However, once the drug has been released, it almost recovers its initial optical properties.

Supercritical Fluid Technology: An Emphasis on Drug Delivery and Related Biomedical Applications

During the past few decades, supercritical fluid (SCF) has emerged as an effective alternative for many traditional pharmaceutical manufacturing processes. Operating active pharmaceutical ingredients (APIs) alone or in combination with various biodegradable polymeric carriers in high-pressure conditions provides enhanced features with respect to their physical properties such as bioavailability enhancement, is of relevance to the application of SCF in the pharmaceutical industry. Herein, recent advances in drug delivery systems manufactured using the SCF technology are reviewed. We provide a brief description of the history, principle, and various preparation methods involved in the SCF technology. Next, we aim to give a brief overview, which provides an emphasis and discussion of recent reports using supercritical carbon dioxide (SC-CO2 ) for fabrication of polymeric carriers, for applications in areas related to drug delivery, tissue engineering, bio-imaging, and other biomedical applications. We finally summarize with perspectives.