Nanoscaled Morphology and Mechanical Properties of a Biomimetic Polymer Surface on a Silicone Hydrogel Contact Lens

Biomedical applications of functional hydrogels: Innovative developments, relevant clinical trials and advanced products

Functional hydrogels are used for numerous biomedical applications such as tissue engineering, wound dressings, lubricants, contact lenses and advanced drug delivery systems. Most of them are based on synthetic or natural polymers forming a three-dimensional network that contains aqueous media. Among synthetic polymers, poly(meth)acrylates, polyethyleneglycols, poly(vinylalcohols), poly(vinylpyrrolidones), PLGA and poly(urethanes) are of high relevance, whereas natural polymers are mainly polysaccharides such as hyaluronic acid, alginate or chitosan and proteins such as albumin, collagen or elastin. In contrast to most synthetic polymers, natural polymers are biodegradable. Both synthetic and natural polymers are often chemically modified in order to improve or induce favorable properties and functions like high mechanical strength, stiffness, elasticity, high porosity, adhesive properties, in situ gelling properties, high water binding capacity or drug release controlling properties. Within this review we provide an overview about the broad spectrum of biomedical applications of functional hydrogels, summarize innovative approaches, discuss the concept of relevant functional hydrogels that are in clinical trials and highlight advanced products as examples for successful developments.

Fluid confinement within a branched polymer structure enhances tribological performance of a poly(2-methacryloyloxyethyl phosphorylcholine)-surface-modified contact lens

The poly(2-methacryloyloxyethyl phosphorylcholine) (PMPC)-modified, silicone hydrogel, contact lens (CL) material lehfilcon A has previously been demonstrated to have a lubricious, antifouling and ultra-soft surface. This study provides confirmatory identification of the outer polymer structures on this CL surface as branched PMPC structures. It further aims to understand their role in providing enhanced tribological performance via fluid confinement. A combination of scanning transmission electron microscopy and atomic force microscopy infrared spectroscopy has been used to achieve both morphological and chemical confirmation of branched PMPC structures resembling the polysaccharide species present on the surface of the cornea. Measurements of the fluid-confinement behaviour of this layer, by means of nanoindentation experiments, show it to resist squeeze-out of the interstitial fluid, thereby boosting lubrication by virtue of a fluid-load-support mechanism. Tribological testing of CLs showed this effective lubrication to be maintained after one month of daily wearing.

Impact of the physical properties of contact lens materials on the discomfort: role of the coefficient of friction

Contact Lens Discomfort (CLD) is the main cause in contact lens (CLs) discontinuation, referred in literature as drop-out phenomenon. Despite such evidence was reported in several clinical studies, a relationship between physico-chemical properties of CLs and CLD is not still totally understood. In this regard, the friction of CLs surfaces seems to be related to discomfort feeling events, probably due to an alteration of the lubricate function of the tear film after the CL placement inside the ocular environment. In the last years, many studies have been finalized to the friction measurements of CLs surface, finding conflicting data due to a lack in standardized protocol. The aim of this review is primarily to show evident relationships between CLs surface properties (i.e. wettability, tear evaporation, tear film quality, etc.) and the coefficient of friction (CoF), resulting therefore the most relevant physical quantity in the CLs characterization. In addition, we reported the most recent studies in CLs tribology, which highlight that the introduction of a standard protocol in CoF measurements is necessary to obtain reproducible results, considering the aim to evaluate in a more precise way the relationship between this material surface property and comfort in CLs users.

Biomimetic polymers with phosphorylcholine groups as biomaterials for medical devices

Biomimetic molecular designs can yield superior biomaterials. Polymers with a phosphorylcholine group, a polar group of phospholipid molecules, are particularly interesting. A methacrylate monomer, 2-methacryloyloxyethyl phosphorylcholine (MPC), was developed using efficient synthetic reactions and purification techniques. This process has been applied in industrial production to supply MPC globally. Polymers with various structures can be readily synthesized using MPC and their properties have been studied. The MPC polymer surface has a highly hydrated structure in biological conditions, leading to the prevention of adsorption of proteins and lipid molecules, adhesion of cells, and inhibition of bacterial adhesion and biofilm formation. Additionally, it provides an extremely lubricious surface. MPC polymers are used in various applications and can be stably immobilized on material surfaces such as metals and ceramics and polymers such as elastomers. They are also stable under sterilization and in vivo conditions. This makes them ideal for application in the surface treatment of various medical devices, including artificial organs, implanted in humans.

Biomimetic-Engineered Silicone Hydrogel Contact Lens Materials

Contact lenses are one of the most successful applications of biomaterials. The chemical structure of the polymers used in contact lenses plays an important role in determining the function of contact lenses. Different types of contact lenses have been developed based on the chemical structure of polymers. When designing contact lenses, materials scientists consider factors such as mechanical properties, processing properties, optical properties, histocompatibility, and antifouling properties, to ensure long-term wear with minimal discomfort. Advances in contact lens materials have addressed traditional issues such as oxygen permeability and biocompatibility, improving overall comfort, and duration of use. For example, silicone hydrogel contact lenses with high oxygen permeability were developed to extend the duration of use. In addition, controlling the surface properties of contact lenses in direct contact with the cornea tissue through surface polymer modification mimics the surface morphology of corneal tissue while maintaining the essential properties of the contact lens, a significant improvement for long-term use and reuse of contact lenses. This review presents the material science elements required for advanced contact lenses of the future and summarizes the chemical methods for achieving these goals.

The Role of Membrane-Tethered Mucins in Axial Epithelial Adhesion in Controlled Normal Stress Environments

The collective adhesive behavior of epithelial cell layers mediated by complex macromolecular fluid environments plays a vital role in many biological processes. Mucins, a family of highly glycosylated proteins, are known to lubricate cell-on-cell contacts in the shear direction. However, the role of mucins mediating axial epithelial adhesion in the direction perpendicular to the plane of the cell sheet has received less attention. This article subjects cell-on-cell layers of live ocular epithelia that express mucins on their apical surfaces to compression/decompression cycles and tensile loading using a customized instrument. In addition to providing compressive moduli of native cell-on-cell layers, it is found that the mucin layer between the epithelia acts as a soft cushion between the epithelial cell layers. Decompression experiments reveal mucin layers act as soft, nonlinear springs in the axial direction. The cell-on-cell layers withstand decompression before fracturing by a cohesive failure within the mucin layer. When mucin deficiency is induced via a protease treatment, it is found that the axial adhesion between the cell layers is increased. The findings which correlate changes in biological factors with changes in mechanical properties might be of interest to challenges in ophthalmology, vision care, and mucus research.

Tear-film evaporation flux and its relationship to tear properties in symptomatic and asymptomatic soft-contact-lens wearers

PURPOSE

With soft-contact-lens wear, evaporation of the pre-lens tear film affects the osmolarity of the post-lens tear film and this can introduce a hyperosmotic environment at the corneal epithelium, leading to discomfort. The purposes of the study are to ascertain whether there are differences in evaporation flux (i.e., the evaporation rate per unit area) between symptomatic and asymptomatic soft-contact-lens wearers, to assess the repeatability of a flow evaporimeter, and to assess the relationship between evaporation fluxes, tear properties, and environmental conditions.

METHODS

Closed-chamber evaporimeters commonly used in ocular-surface research do not control relative humidity and airflow, and, therefore, misestimate the actual tear-evaporation flux. A recently developed flow evaporimeter overcomes these limitations and was used to measure accurate in-vivo tear-evaporation fluxes with and without soft-contact-lens wear for symptomatic and asymptomatic habitual contact-lens wearers. Concomitantly, lipid-layer thickness, ocular-surface-temperature decline rate (i.e., °C/s), non-invasive tear break-up time, tear-meniscus height, Schirmer tear test, and environmental conditions were measured in a 5 visit study.

RESULTS

Twenty-one symptomatic and 21 asymptomatic soft-contact-lens wearers completed the study. A thicker lipid layer was associated with slower evaporation flux (p < 0.001); higher evaporation flux was associated with faster tear breakup irrespective of lens wear (p = 0.006). Higher evaporation flux was also associated with faster ocular-surface-temperature decline rate (p < 0.001). Symptomatic lens wearers exhibited higher evaporation flux than did asymptomatic lens wearers, however, the results did not reach statistical significance (p = 0.053). Evaporation flux with lens wear was higher than without lens wear but was also not statistically significant (p = 0.110).

CONCLUSIONS

The repeatability of the Berkeley flow evaporimeter, associations between tear characteristics and evaporation flux, sample-size estimates, and near statistical significance in tear-evaporation flux between symptomatic and asymptomatic lens wearers all suggest that with sufficient sample sizes, the flow evaporimeter is a viable research tool to understand soft-contact-lens wear comfort.

Zwitterionic Biomaterials

The term "zwitterionic polymers" refers to polymers that bear a pair of oppositely charged groups in their repeating units. When these oppositely charged groups are equally distributed at the molecular level, the molecules exhibit an overall neutral charge with a strong hydration effect via ionic solvation. The strong hydration effect constitutes the foundation of a series of exceptional properties of zwitterionic materials, including resistance to protein adsorption, lubrication at interfaces, promotion of protein stabilities, antifreezing in solutions, etc. As a result, zwitterionic materials have drawn great attention in biomedical and engineering applications in recent years. In this review, we give a comprehensive and panoramic overview of zwitterionic materials, covering the fundamentals of hydration and nonfouling behaviors, different types of zwitterionic surfaces and polymers, and their biomedical applications.

Surface characterization of an ultra-soft contact lens material using an atomic force microscopy nanoindentation method

As new ultra-soft materials are being developed for medical devices and biomedical applications, the comprehensive characterization of their physical and mechanical properties is both critical and challenging. To characterize the very low surface modulus of the novel biomimetic lehfilcon A silicone hydrogel contact lens coated with a layer of a branched polymer brush structure, an improved atomic force microscopy (AFM) nanoindentation method has been applied. This technique allows for precise contact-point determination without the effects of viscous squeeze-out upon approaching the branched polymer. Additionally, it allows individual brush elements to be mechanically characterized in the absence of poroelastic effects. This was accomplished by selecting an AFM probe with a design (tip size, geometry, and spring constant) that was especially suited to measuring the properties of soft materials and biological samples. The enhanced sensitivity and accuracy of this method allows for the precise measurement of the very soft lehfilcon A material, which has an extremely low elastic modulus in the surface region (as low as 2 kPa) and extremely high elasticity (nearly 100%) in an aqueous environment. The surface-characterization results not only reveal the ultra-soft nature of the lehfilcon A lens surface but also demonstrate that the elastic modulus exhibits a 30 kPa/200 nm gradient with depth due to the disparity between the modulus of the branched polymer brushes and the SiHy substrate. This surface-characterization methodology may be applied to other ultra-soft materials and medical devices.

Biomimetic materials based on zwitterionic polymers toward human-friendly medical devices

This review summarizes recent research on the design of polymer material systems based on biomimetic concepts and reports on the medical devices that implement these systems. Biomolecules such as proteins, nucleic acids, and phospholipids, present in living organisms, play important roles in biological activities. These molecules are characterized by heterogenic nature with hydrophilicity and hydrophobicity, and a balance of positive and negative charges, which provide unique reaction fields, interfaces, and functionality. Incorporating these molecules into artificial systems is expected to advance material science considerably. This approach to material design is exceptionally practical for medical devices that are in contact with living organisms. Here, it is focused on zwitterionic polymers with intramolecularly balanced charges and introduce examples of their applications in medical devices. Their unique properties make these polymers potential surface modification materials to enhance the performance and safety of conventional medical devices. This review discusses these devices; moreover, new surface technologies have been summarized for developing human-friendly medical devices using zwitterionic polymers in the cardiovascular, cerebrovascular, orthopedic, and ophthalmology fields.

Soft Contact Mechanics with Gradient-Stiffness Surfaces

The stiffness in the top surface of many biological entities like cornea or articular cartilage, as well as chemically cross-linked synthetic hydrogels, can be significantly lower or more compliant than the bulk. When such a heterogeneous surface comes into contact, the contacting load is distributed differently from typical contact models. The mechanical response under indentation loading of a surface with a gradient of stiffness is a complex, integrated response that necessarily includes the heterogeneity. In this work, we identify empirical contact models between a rigid indenter and gradient elastic surfaces by numerically simulating quasi-static indentation. Three key case studies revealed the specific ways in which (I) continuous gradients, (II) laminate-layer gradients, and (III) alternating gradients generate new contact mechanics at the shallow-depth limit. Validation of the simulation-generated models was done by micro- and nanoindentation experiments on polyacrylamide samples synthesized to have a softer gradient surface layer. The field of stress and stretch in the subsurface as visualized from the simulations also reveals that the gradient layers become confined, which pushes the stretch fields closer to the surface and radially outward. Thus, contact areas are larger than expected, and average contact pressures are lower than predicted by the Hertz model. The overall findings of this work are new contact models and the mechanisms by which they change. These models allow a more accurate interpretation of the plethora of indentation data on surface gradient soft matter (biological and synthetic) as well as a better prediction of the force response to gradient soft surfaces. This work provides examples of how gradient hydrogel surfaces control the subsurface stress distribution and loading response.

Recent progress and perspectives in applications of 2-methacryloyloxyethyl phosphorylcholine polymers in biodevices at small scales

Bioinspired materials have attracted attention in a wide range of fields. Among these materials, a polymer family containing 2-methacryloyloxyethyl phosphorylcholine (MPC), which has a zwitterionic phosphorylcholine headgroup inspired by the...