The Influence of the Dropsize on the Elimination of an Ophthalmic Solution from the Precorneal Area of Human Eyes

The design of contact lens based ocular drug delivery systems for single-day use: Part (I) Structural factors, surrogate ophthalmic dyes and passive diffusion studies

The poor retention and efficacy of instilled drops as a means of delivering drugs to the ophthalmic environment is well-recognised. The potential value of contact lenses as a means of ophthalmic drug delivery, and consequent improvement of pre-corneal retention is one obvious route to the development of a more effective ocular delivery system. Furthermore, the increasing availability and clinical use of daily disposable contact lenses provides the platform for the development of viable single-day use drug delivery devices based on existing materials and lenses. In order to provide a basis for the effective design of such devices, a systematic understanding of the factors affecting the interaction of individual drugs with the lens matrix is required. Because a large number of potential structural variables are involved, it is necessary to achieve some rationalisation of the parameters and physicochemical properties (such as molecular weight, charge, partition coefficients) that influence drug interactions. Ophthalmic dyes and structurally related compounds based on the same core structure were used to investigate these various factors and the way in which they can be used in concert to design effective release systems for structurally different drugs. Initial studies of passive diffusional release form a necessary precursor to the investigation of the features of the ocular environment that over-ride this simple behaviour. Commercially available contact lenses of differing structural classifications were used to study factors affecting the uptake of the surrogate actives and their release under ‘passive’ conditions. The interaction between active and lens material shows considerable and complex structure dependence, which is not simply related to equilibrium water content. The structure of the polymer matrix itself was found to have the dominant controlling influence on active uptake; hydrophobic interaction with the ophthalmic dye playing a major role.

Use of a high molecular weight fluorescein (fluorexon) ophthalmic strip in assessments of tear film break-up time in contact lens wearers and non-contact lens wearers

PURPOSE

To assess whether fluorexon strips could be used in tear stability [tear film break-up time (TBUT)] measures, as compared with fluorescein strips.

METHODS

The pre-ocular tear film stability was assessed in 40 adults (19-29 years of age), half of whom were adapted soft contact lens wearers, using the dye-assisted tear film break-up time (TBUT) method. The measures were carried out between 10.00 and 17.00 hours, with contact lens wearers removing their lenses just before the assessments. For all subjects, fluorescein or fluorexon ophthalmic strips (pre-wetted with preservative-free saline) were used to add dye to the tear film, the TBUT was assessed three times and then the eye lightly irrigated with saline. The measures were repeated 45 min later with the other dye, with half the subjects receiving fluorescein first and the other half receiving fluorexon first.

RESULTS

Overall, the mean TBUT times were 12.2 +/- 5.9 s for fluorescein and 12.6 +/- 5.6 s for fluorexon (p = n.s.), but the non-lens wearers had longer TBUT times (14.6 and 14.5 s for the two dyes) compared with contact lens wearers (9.8 and 10.7 s, p < 0.01). While the inter-subject variability (as S.D.) was larger for non-contact lens wearers, the intra-subject variability [as coefficient of variation (COV)] was greater in the contact lens wearers when fluorescein was used (p < 0.001). When analysed as a function of the time of day that the measures were made, there were clear trends for both the fluorescein and fluorexon. TBUT values to increase in non-contact lens wearers and decrease in contact lens wearers. These trends failed to reach statistical significance, but the results with the contact lens wearers showed less variation than the non-contact lens wearers.

CONCLUSION

The use of a fluorexon dye-impregnated strip (pre-wetted with preservative-free saline) yielded comparable results with a fluorescein strip for assessments of tear film stability based on TBUT. The studies also indicate that further research is needed on changes in TBUT values during the day.

In-vivo studies on dexamethasone sodium phosphate liposomes

Dexamethasone Sodium Phosphate (DSP) is a water soluble anti-inflammatory steroid commonly used in the therapy of serious types of ophthalmic inflammation. It has been demonstrated that unless the corneal epithelium is damaged, DSP is poorly absorbed by the cornea (Kupferman et al. 1974). Thus, it is doubtful whether such a drug would cure inflammation of the anterior segments. For this purpose, several liposomal DSP formulations containing phospholipid: charge inducer: cholesterol in molar ratios of 10:1:4 were investigated. Both gel state (PL 90H: SA: Cho1) and liquid state (PL 100: SA: Cho1) liposomes were prepared. For the preparation of liposomes, the film method followed by bath sonication was used. Liposomes were labelled with (99m)-Tc and administered intra-ocularly to New Zealand white rabbits weighing 2.5-3 kg for in vivo experiments. The biodistribution of the labelled liposomes were determined. For this purpose, eye segments (such as cornea, lens, iris, ciliar body, vitreous, aqueous humor, conjuctiva and sclera) and RES organs (such as liver, pancreas, spleen) were removed at fixed time intervals. In the present study, the efficiency of liposomes for the delivery of water-soluble drugs was evaluated in rabbit eyes using DSP as a model drug in different liposomal formulations.