1
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Krawczyk A, Stadler SM, Strzalka-Mrozik B. Nanomedicines for Dry Eye Syndrome: Targeting Oxidative Stress with Modern Nanomaterial Strategies. Molecules 2024; 29:3732. [PMID: 39202812 PMCID: PMC11357096 DOI: 10.3390/molecules29163732] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2024] [Revised: 08/03/2024] [Accepted: 08/05/2024] [Indexed: 09/03/2024] Open
Abstract
Dry eye syndrome (DES) is a dynamic, chronic disease of the ocular surface and ocular appendages caused by inflammation. The most common symptoms include redness, itching, and blurred vision, resulting from dysfunction of the meibomian glands and impaired tear-film production. Factors contributing to the development of DES include environmental elements, such as UV radiation, and internal elements, such as hormonal imbalances. These factors increase oxidative stress, which exacerbates inflammation on the surface of the eye and accelerates the development of DES. In recent years, the incidence of DES has risen, leading to a greater need to develop effective treatments. Current treatments for dry eye are limited and primarily focus on alleviating individual symptoms, such as reducing inflammation of the ocular surface. However, it is crucial to understand the pathomechanism of the disease and tailor treatment to address the underlying causes to achieve the best possible therapeutic outcomes. Therefore, in this review, we analyzed the impact of oxidative stress on the development of DES to gain a better understanding of its pathomechanism and examined recently developed nanosystems that allow drugs to be delivered directly to the disease site.
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Affiliation(s)
| | | | - Barbara Strzalka-Mrozik
- Department of Molecular Biology, Faculty of Pharmaceutical Sciences in Sosnowiec, Medical University of Silesia, 40-055 Katowice, Poland; (A.K.); (S.M.S.)
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2
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Naik K, Du Toit LC, Ally N, Choonara YE. Advances in Polysaccharide- and Synthetic Polymer-Based Vitreous Substitutes. Pharmaceutics 2023; 15:566. [PMID: 36839888 PMCID: PMC9961338 DOI: 10.3390/pharmaceutics15020566] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2023] [Revised: 02/01/2023] [Accepted: 02/05/2023] [Indexed: 02/11/2023] Open
Abstract
The vitreous humour is a gel-like structure that composes the majority of each eye. It functions to provide passage of light, be a viscoelastic dampener, and hold the retina in place. Vitreous liquefaction causes retinal detachment and retinal tears requiring pars plana vitrectomy for vitreous substitution. An ideal vitreous substitute should display similar mechanical, chemical, and rheological properties to the natural vitreous. Currently used vitreous substitutes such as silicone oil, perfluorocarbon liquids, and gases cannot be used long-term due to adverse effects such as poor retention time, cytotoxicity, and cataract formation. Long-term, experimental vitreous substitutes composed of natural, modified and synthetic polymers are currently being studied. This review discusses current long- and short-term vitreous substitutes and the disadvantages of these that have highlighted the need for an ideal vitreous substitute. The review subsequently focuses specifically on currently used polysaccharide- and synthetic polymer-based vitreous substitutes, which may be modified or functionalised, or employed as the derivative, and discusses experimental vitreous substitutes in these classes. The advantages and challenges associated with the use of polymeric substitutes are discussed. Innovative approaches to vitreous substitution, namely a novel foldable capsular vitreous body, are presented, as well as future perspectives related to the advancement of this field.
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Affiliation(s)
- Kruti Naik
- Wits Advanced Drug Delivery Platform Research Unit, Department of Pharmacy and Pharmacology, School of Therapeutic Sciences, Faculty of Health Sciences, University of the Witwatersrand, 7 York Road, Parktown, Johannesburg 2193, South Africa
| | - Lisa C. Du Toit
- Wits Advanced Drug Delivery Platform Research Unit, Department of Pharmacy and Pharmacology, School of Therapeutic Sciences, Faculty of Health Sciences, University of the Witwatersrand, 7 York Road, Parktown, Johannesburg 2193, South Africa
| | - Naseer Ally
- Division of Ophthalmology, Department of Neurosciences, School of Clinical Medicine, Faculty of Health Sciences, University of the Witwatersrand, 7 York Road, Parktown, Johannesburg 2193, South Africa
| | - Yahya E. Choonara
- Wits Advanced Drug Delivery Platform Research Unit, Department of Pharmacy and Pharmacology, School of Therapeutic Sciences, Faculty of Health Sciences, University of the Witwatersrand, 7 York Road, Parktown, Johannesburg 2193, South Africa
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3
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Confalonieri F, Josifovska N, Boix-Lemonche G, Stene-Johansen I, Bragadottir R, Lumi X, Petrovski G. Vitreous Substitutes from Bench to the Operating Room in a Translational Approach: Review and Future Endeavors in Vitreoretinal Surgery. Int J Mol Sci 2023; 24:3342. [PMID: 36834754 PMCID: PMC9961686 DOI: 10.3390/ijms24043342] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2022] [Revised: 01/24/2023] [Accepted: 02/02/2023] [Indexed: 02/11/2023] Open
Abstract
Vitreous substitutes are indispensable tools in vitreoretinal surgery. The two crucial functions of these substitutes are their ability to displace intravitreal fluid from the retinal surface and to allow the retina to adhere to the retinal pigment epithelium. Today, vitreoretinal surgeons can choose among a plethora of vitreous tamponades, and the tamponade of choice might be difficult to determine in the ever-expanding range of possibilities for a favorable outcome. The currently available vitreous substitutes have disadvantages that need to be addressed to improve the surgical outcome achievable today. Herein, the fundamental physical and chemical proprieties of all vitreous substitutes are reported, and their use and clinical applications are described alongside some surgical techniques of intra-operative manipulation. The major upcoming developments in vitreous substitutes are extensively discussed, keeping a translational perspective throughout. Conclusions on future perspectives are derived through an in-depth analysis of what is lacking today in terms of desired outcomes and biomaterials technology.
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Affiliation(s)
- Filippo Confalonieri
- Department of Ophthalmology, Oslo University Hospital, Kirkeveien 166, 0450 Oslo, Norway
- Center for Eye Research and Innovative Diagnostics, Department of Ophthalmology, Institute for Clinical Medicine, University of Oslo, Kirkeveien 166, 0450 Oslo, Norway
- Department of Biomedical Sciences, Humanitas University, Via Rita Levi Montalcini 4, Pieve Emanuele, 20090 Milan, Italy
| | - Natasha Josifovska
- Center for Eye Research and Innovative Diagnostics, Department of Ophthalmology, Institute for Clinical Medicine, University of Oslo, Kirkeveien 166, 0450 Oslo, Norway
| | - Gerard Boix-Lemonche
- Center for Eye Research and Innovative Diagnostics, Department of Ophthalmology, Institute for Clinical Medicine, University of Oslo, Kirkeveien 166, 0450 Oslo, Norway
| | - Ingar Stene-Johansen
- Department of Ophthalmology, Oslo University Hospital, Kirkeveien 166, 0450 Oslo, Norway
| | - Ragnheidur Bragadottir
- Department of Ophthalmology, Oslo University Hospital, Kirkeveien 166, 0450 Oslo, Norway
- Center for Eye Research and Innovative Diagnostics, Department of Ophthalmology, Institute for Clinical Medicine, University of Oslo, Kirkeveien 166, 0450 Oslo, Norway
| | - Xhevat Lumi
- Center for Eye Research and Innovative Diagnostics, Department of Ophthalmology, Institute for Clinical Medicine, University of Oslo, Kirkeveien 166, 0450 Oslo, Norway
- Eye Hospital, University Medical Centre Ljubljana, Zaloška cesta 7, 1000 Ljubljana, Slovenia
| | - Goran Petrovski
- Department of Ophthalmology, Oslo University Hospital, Kirkeveien 166, 0450 Oslo, Norway
- Center for Eye Research and Innovative Diagnostics, Department of Ophthalmology, Institute for Clinical Medicine, University of Oslo, Kirkeveien 166, 0450 Oslo, Norway
- Department of Ophthalmology, University of Split School of Medicine and University Hospital Centre, 21000 Split, Croatia
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4
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Seah I, Ong C, Liu Z, Su X. Polymeric biomaterials in the treatment of posterior segment diseases. Front Med (Lausanne) 2022; 9:949543. [PMID: 36059842 PMCID: PMC9433984 DOI: 10.3389/fmed.2022.949543] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2022] [Accepted: 07/28/2022] [Indexed: 11/13/2022] Open
Abstract
Polymeric biomaterials are biological or synthetic substances which can be engineered to interact with biological systems for the diagnosis or treatment of diseases. These biomaterials have immense potential for treating eyes diseases, particularly the retina—a site of many inherited and acquired diseases. Polymeric biomaterials can be engineered to function both as an endotamponade agent and to prevent intraocular scarring in retinal detachment repair surgeries. They can also be designed as a drug delivery platform for treatment of retinal diseases. Finally, they can be used as scaffolds for cellular products and provide non-viral gene delivery solutions to the retina. This perspective article explains the role of polymeric biomaterials in the treatment of retinal conditions by highlighting recent advances being translated to clinical practice. The article will also identify potential hurdles to clinical translation as future research directions in the field.
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Affiliation(s)
- Ivan Seah
- Department of Ophthalmology, National University Hospital, Singapore, Singapore
- Department of Ophthalmology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
- Institute of Molecular and Cell Biology (IMCB), Agency for Science, Technology and Research (ASTAR), Singapore, Singapore
| | - Charles Ong
- Singapore National Eye Centre (SNEC), Singapore, Singapore
| | - Zengping Liu
- Department of Ophthalmology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
- Institute of Molecular and Cell Biology (IMCB), Agency for Science, Technology and Research (ASTAR), Singapore, Singapore
- Singapore Eye Research Institute (SERI), Singapore, Singapore
| | - Xinyi Su
- Department of Ophthalmology, National University Hospital, Singapore, Singapore
- Department of Ophthalmology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
- Institute of Molecular and Cell Biology (IMCB), Agency for Science, Technology and Research (ASTAR), Singapore, Singapore
- Singapore Eye Research Institute (SERI), Singapore, Singapore
- *Correspondence: Xinyi Su
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5
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Bercea M. Bioinspired Hydrogels as Platforms for Life-Science Applications: Challenges and Opportunities. Polymers (Basel) 2022; 14:polym14122365. [PMID: 35745941 PMCID: PMC9229923 DOI: 10.3390/polym14122365] [Citation(s) in RCA: 16] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2022] [Revised: 06/08/2022] [Accepted: 06/09/2022] [Indexed: 12/13/2022] Open
Abstract
Hydrogels, as interconnected networks (polymer mesh; physically, chemically, or dynamic crosslinked networks) incorporating a high amount of water, present structural characteristics similar to soft natural tissue. They enable the diffusion of different molecules (ions, drugs, and grow factors) and have the ability to take over the action of external factors. Their nature provides a wide variety of raw materials and inspiration for functional soft matter obtained by complex mechanisms and hierarchical self-assembly. Over the last decade, many studies focused on developing innovative and high-performance materials, with new or improved functions, by mimicking biological structures at different length scales. Hydrogels with natural or synthetic origin can be engineered as bulk materials, micro- or nanoparticles, patches, membranes, supramolecular pathways, bio-inks, etc. The specific features of hydrogels make them suitable for a wide variety of applications, including tissue engineering scaffolds (repair/regeneration), wound healing, drug delivery carriers, bio-inks, soft robotics, sensors, actuators, catalysis, food safety, and hygiene products. This review is focused on recent advances in the field of bioinspired hydrogels that can serve as platforms for life-science applications. A brief outlook on the actual trends and future directions is also presented.
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Affiliation(s)
- Maria Bercea
- "Petru Poni" Institute of Macromolecular Chemistry, 700487 Iasi, Romania
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6
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Injectable self-crosslinking hydrogels based on hyaluronic acid as vitreous substitutes. Int J Biol Macromol 2022; 208:159-171. [PMID: 35301003 DOI: 10.1016/j.ijbiomac.2022.03.046] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2021] [Revised: 02/16/2022] [Accepted: 03/09/2022] [Indexed: 02/07/2023]
Abstract
After vitrectomy, the ideal vitreous substitute should be implanted to maintain the normal function of the eye. However, the existing materials (such as silicone oil, air, perfluorocarbons, etc.) still have some shortcomings and cannot fully meet the clinical needs. In this study, thiolated hyaluronic acid (SH-HA) was prepared based on hyaluronic acid. The SH-HA hydrogel was formed by a simple transformation of the sulfhydryl group to the disulfide bond, which had high transparency, controllable swelling property, suitable mechanical strength, excellent biocompatibility and similar physical and chemical properties to natural vitreous. SH-HA hydrogel was filled into the eyes of experimental rabbits to replace their own vitreous after vitrectomy. During the 90 days follow-up period, SH-HA hydrogel showed excellent intraocular compatibility, maintained normal intraocular pressure (IOP), and no cataract, endophthalmitis, retinal detachment and other complications were observed. In general, SH-HA hydrogel has great potential as a vitreous substitute.
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7
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Ran C, Wang J, He Y, Ren Q, Hu H, Zhu J, Gu X, Li M, Zheng L, Li J. Recent Advances in Bioinspired Hydrogels with Environment- Responsive Characteristics for Biomedical Applications. Macromol Biosci 2022; 22:e2100474. [PMID: 35089646 DOI: 10.1002/mabi.202100474] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2021] [Revised: 12/25/2021] [Indexed: 11/12/2022]
Abstract
The development of hydrogel-integrated soft materials via the incorporation of therapeutic medicines into bio-compatible hydrogels, serving as host, will significantly contribute to advances in medical diagnosis and treatment. Furthermore, intelligent hydrogels having the ability to respond to local environmental conditions offer a promising approach for the development of novel solutions in the biomedical field. Bioinspired intelligent hydrogels are now becoming a potentially powerful biomaterial class for tissue engineering, drug delivery, and medical device. Recent advances include bioinspired intelligent hydrogels that possess unique mechanical and optical properties as a result of their nature-inspired complex-structured design. In this review, we highlight the latest advances in intelligent bionic hydrogels, as well as strategies targeting smart response of their characteristics across multiple dimensions (such as temperature, light, pH, among others). Finally, the potential development and prospective application of mimicking the natural intelligence of multifunctional medical hydrogels are also discussed. This article is protected by copyright. All rights reserved.
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Affiliation(s)
- Chao Ran
- Department of Hepatobiliary Surgery, the Second Affiliated Hospital of Army Medical University, Chongqing, 400037, China
| | - Jiacheng Wang
- MOE Key Laboratory of Low-grade Energy Utilization Technologies and Systems, CQU-NUS Renewable Energy Materials & Devices Joint Laboratory, School of Energy & Power Engineering, Chongqing University, Chongqing, 400044, China
| | - Yonggang He
- Department of Hepatobiliary Surgery, the Second Affiliated Hospital of Army Medical University, Chongqing, 400037, China
| | - Qian Ren
- Department of Hepatobiliary Surgery, the Second Affiliated Hospital of Army Medical University, Chongqing, 400037, China
| | - Hao Hu
- Department of Hepatobiliary Surgery, the Second Affiliated Hospital of Army Medical University, Chongqing, 400037, China
| | - Jiangqin Zhu
- Department of Hepatobiliary Surgery, the Second Affiliated Hospital of Army Medical University, Chongqing, 400037, China
| | - Xunxin Gu
- Department of Hepatobiliary Surgery, the Second Affiliated Hospital of Army Medical University, Chongqing, 400037, China
| | - Meng Li
- MOE Key Laboratory of Low-grade Energy Utilization Technologies and Systems, CQU-NUS Renewable Energy Materials & Devices Joint Laboratory, School of Energy & Power Engineering, Chongqing University, Chongqing, 400044, China
| | - Lu Zheng
- Department of Hepatobiliary Surgery, the Second Affiliated Hospital of Army Medical University, Chongqing, 400037, China
| | - Jing Li
- Department of Hepatobiliary Surgery, the Second Affiliated Hospital of Army Medical University, Chongqing, 400037, China
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8
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Ran R, Shi W, Gao Y, Wang T, Ren X, Chen Y, Wu X, Cao J, Zhang M. Super-fast in situ formation of hydrogels based on multi-arm functional polyethylene glycols as endotamponade substitutes. J Mater Chem B 2021; 9:9162-9173. [PMID: 34697622 DOI: 10.1039/d1tb01825f] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
Polymer-based hydrogels used in the vitreous cavity could lead to an unsatisfactory gel-forming state, uncontrollable swelling, and potential cytotoxicity. Their application can significantly impair the filling effect and cause severe side effects in the surrounding tissues. To address the concerns, a poly(ethylene glycol)-engineered hydrogel capable of fast in situ gel formation (less than 1 min), with an ultralow swelling ratio and no cytotoxicity in the rabbits' eyes, was constructed as a vitreous substitute. The multi-arm polyethylene glycols (PEGs) modified with functional groups (thiol and maleimide) possess high reaction efficiency in the vitreous cavity and present excellent biomimetic characteristics of the natural vitreous humor in vitro. After injection with a double syringe via a 25-gauge needle in the eyes of rabbits for 6 months, the hydrogel functioned as an artificial vitreous body that could highly promote retinal detachment repair, with excellent biocompatibility and high transparency, and without bio-degradation or ocular complications. Collectively, the fast in situ forming hydrogel could achieve quick and good filling in the vitreous cavity without cytotoxicity, which makes it a promising long-term endotamponade substitute.
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Affiliation(s)
- Ruijin Ran
- Department of Ophthalmology, West China Hospital of Sichuan University, No. 37 Guoxue Lane, Wuhou District, Chengdu 610041, China. .,Minda Hospital of Hubei Minzu University, Enshi 445000, China
| | - Wenqiang Shi
- National Engineering Research Center for Biomaterials, Sichuan University, Chengdu 610064, China.
| | - Yunxia Gao
- Department of Ophthalmology, West China Hospital of Sichuan University, No. 37 Guoxue Lane, Wuhou District, Chengdu 610041, China.
| | - Ting Wang
- Department of Ophthalmology, West China Hospital of Sichuan University, No. 37 Guoxue Lane, Wuhou District, Chengdu 610041, China.
| | - Xiang Ren
- Department of Ophthalmology, West China Hospital of Sichuan University, No. 37 Guoxue Lane, Wuhou District, Chengdu 610041, China.
| | - Yi Chen
- Department of Ophthalmology, West China Hospital of Sichuan University, No. 37 Guoxue Lane, Wuhou District, Chengdu 610041, China.
| | - Xue Wu
- Department of Ophthalmology, West China Hospital of Sichuan University, No. 37 Guoxue Lane, Wuhou District, Chengdu 610041, China.
| | - Jun Cao
- National Engineering Research Center for Biomaterials, Sichuan University, Chengdu 610064, China.
| | - Ming Zhang
- Department of Ophthalmology, West China Hospital of Sichuan University, No. 37 Guoxue Lane, Wuhou District, Chengdu 610041, China.
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Lin KT, Wang A, Nguyen AB, Iyer J, Tran SD. Recent Advances in Hydrogels: Ophthalmic Applications in Cell Delivery, Vitreous Substitutes, and Ocular Adhesives. Biomedicines 2021; 9:1203. [PMID: 34572389 PMCID: PMC8471559 DOI: 10.3390/biomedicines9091203] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2021] [Revised: 09/06/2021] [Accepted: 09/09/2021] [Indexed: 11/17/2022] Open
Abstract
With the prevalence of eye diseases, such as cataracts, retinal degenerative diseases, and glaucoma, different treatments including lens replacement, vitrectomy, and stem cell transplantation have been developed; however, they are not without their respective shortcomings. For example, current methods to seal corneal incisions induced by cataract surgery, such as suturing and stromal hydration, are less than ideal due to the potential for surgically induced astigmatism or wound leakage. Vitrectomy performed on patients with diabetic retinopathy requires an artificial vitreous substitute, with current offerings having many shortcomings such as retinal toxicity. The use of stem cells has also been investigated in retinal degenerative diseases; however, an optimal delivery system is required for successful transplantation. The incorporation of hydrogels into ocular therapy has been a critical focus in overcoming the limitations of current treatments. Previous reviews have extensively documented the use of hydrogels in drug delivery; thus, the goal of this review is to discuss recent advances in hydrogel technology in surgical applications, including dendrimer and gelatin-based hydrogels for ocular adhesives and a variety of different polymers for vitreous substitutes, as well as recent advances in hydrogel-based retinal pigment epithelium (RPE) and retinal progenitor cell (RPC) delivery to the retina.
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Affiliation(s)
| | | | | | | | - Simon D. Tran
- McGill Craniofacial Tissue Engineering and Stem Cells Laboratory, Faculty of Dentistry, McGill University, 3640 University Street, Montreal, QC H3A 0C7, Canada; (K.T.L.); (A.W.); (A.B.N.); (J.I.)
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10
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de Oliveira RA, Muralha FP, Grupenmacher AT, de Araújo Morandim-Giannetti A, Bersanetti PA, Maia M, Magalhães Junior O. Biocompatibility of polyvinyl alcohol/trisodium trimetaphosphate as vitreous substitute in experimental vitrectomy model in rabbits. J Biomed Mater Res B Appl Biomater 2021; 110:460-466. [PMID: 34328263 DOI: 10.1002/jbm.b.34923] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2021] [Revised: 06/12/2021] [Accepted: 07/08/2021] [Indexed: 11/06/2022]
Abstract
Synthetic hydrogels have been proposed as vitreous substitutes recently. This study aims to evaluate the biocompatibility of polyvinyl alcohol (PVA) crosslinked with trisodium trimetaphosphate (SMTP) hydrogel in rabbit vitrectomized eyes. Seven animals were submitted to pars plana vitrectomy and the vitreous was replaced by PVA/SMTP hydrogel. Optical coherence tomography, fluorescein angiogram, clinical, and electrophysiological (ERG) examinations were analyzed at baseline, on postoperative days 7 and 30. The fellow eye was used as the control group. Hydrogel opacification was observed and ERG recordings were reduced in the hydrogel group in rod response, b-wave cone response and flicker. A histological analysis showed retinal disorganization, presence of multinucleated cells, and intraretinal hydrogel particles. The PVA/SMTP hydrogel showed poor biocompatibility. Novel biomaterials compounds should be analyzed in vivo.
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Affiliation(s)
- Ramon Antunes de Oliveira
- Department of Ophthalmology and Visual Sciences, Escola Paulista de Medicina, Universidade Federal de São Paulo, São Paulo, Brazil
| | - Felipe Picanço Muralha
- Department of Ophthalmology and Visual Sciences, Escola Paulista de Medicina, Universidade Federal de São Paulo, São Paulo, Brazil
| | - Alex Treiger Grupenmacher
- Department of Ophthalmology and Visual Sciences, Escola Paulista de Medicina, Universidade Federal de São Paulo, São Paulo, Brazil
| | | | | | - Maurício Maia
- Department of Ophthalmology and Visual Sciences, Escola Paulista de Medicina, Universidade Federal de São Paulo, São Paulo, Brazil
| | - Octaviano Magalhães Junior
- Department of Ophthalmology and Visual Sciences, Escola Paulista de Medicina, Universidade Federal de São Paulo, São Paulo, Brazil
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11
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Wang T, Ran R, Ma Y, Zhang M. Polymeric hydrogel as a vitreous substitute: current research, challenges, and future directions. Biomed Mater 2021; 16. [PMID: 34038870 DOI: 10.1088/1748-605x/ac058e] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2021] [Accepted: 05/26/2021] [Indexed: 02/08/2023]
Abstract
Vitreoretinal surgery is an essential approach to treat proliferative diabetic vitreopathy, retinal detachment, retinal tear, ocular trauma, and macular holes. The removal of the natural vitreous and the replacement with substitutes are critical steps for retina reattachment. Vitreous substitutes including silicone oil (SiO), air, sulfur hexafluoride (SF6), and perfluoropropane (C3F8), have been widely applied in clinical practice. However, these substitutes are reported to cause complications such as emulsification, high intraocular pressure, and lens opacification. Polymeric hydrogels are a kind of material with favorable physical, mechanical properties, and adaptable biocompatibility, thus being highly expected to be ideal vitreous substitutes. Despite years of research, very few polymeric hydrogels can be applied practically in the vitreous cavity. In this review, we focus on the development of polymeric natural-based hydrogels and synthetic hydrogels. Particularly, we pay attention to recent advances in the novel stimuli-response and self-assembly supramolecular hydrogels. Characterized by easy injectability and long residence time, this kind of hydrogel becomes the potentially promising candidates for ideal vitreous substitutes. Finally, we evaluate the current challenges and provide the future directions of vitreous substitutes.
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Affiliation(s)
- Ting Wang
- Department of Ophthalmology, West China Hospital, Sichuan University, Chengdu 610041, People's Republic of China.,West China School of Medicine, West China Hospital, Sichuan University, Chengdu 610041, People's Republic of China
| | - Ruijin Ran
- Department of Ophthalmology, West China Hospital, Sichuan University, Chengdu 610041, People's Republic of China.,Minda Hospital of Hubei Minzu University, Enshi, People's Republic of China
| | - Yan Ma
- State Key Laboratory of Coordination Chemistry, School of Chemistry and Chemical Engineering, Nanjing University, Nanjing 210023, People's Republic of China
| | - Ming Zhang
- Department of Ophthalmology, West China Hospital, Sichuan University, Chengdu 610041, People's Republic of China
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12
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Mondelo-García C, Bandín-Vilar E, García-Quintanilla L, Castro-Balado A, Del Amo EM, Gil-Martínez M, Blanco-Teijeiro MJ, González-Barcia M, Zarra-Ferro I, Fernández-Ferreiro A, Otero-Espinar FJ. Current Situation and Challenges in Vitreous Substitutes. Macromol Biosci 2021; 21:e2100066. [PMID: 33987966 DOI: 10.1002/mabi.202100066] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2021] [Revised: 04/23/2021] [Indexed: 12/11/2022]
Abstract
Vitreo-retinal disorders constitute a significant portion of treatable ocular diseases. These pathologies often require vitreo-retinal surgery and, as a consequence, the use of vitreous substitutes. Nowadays, the vitreous substitutes that are used in clinical practice are mainly divided into gases (air, SF6 , C2 F6 , C3 F8 ) and liquids (perfluorocarbon liquids, silicone oils, and heavy silicone oils). There are specific advantages and drawbacks to each of these, which determine their clinical indications. However, developing the ideal biomaterial for vitreous substitution continues to be one of the most important challenges in ophthalmology, and a multidisciplinary approach is required. In this sense, recent research has focused on the development of biocompatible, biodegradable, and injectable hydrogels (natural, synthetic, and smart), which also act as medium and long-term internal tamponade agents. This comprehensive review aims to cover the main characteristics and indications for use of the extensive range of vitreous substitutes that are currently used in clinical practice, before going on to describe the hydrogels that have been developed recently and which have emerged as promising biomaterials for vitreous substitution.
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Affiliation(s)
- Cristina Mondelo-García
- Pharmacy Department, University Clinical Hospital of Santiago de Compostela (SERGAS), Santiago de Compostela, 15706, Spain.,Pharmacology Group, Health Research Institute of Santiago de Compostela (FIDIS), Santiago de Compostela, 15706, Spain
| | - Enrique Bandín-Vilar
- Pharmacy Department, University Clinical Hospital of Santiago de Compostela (SERGAS), Santiago de Compostela, 15706, Spain.,Pharmacology Group, Health Research Institute of Santiago de Compostela (FIDIS), Santiago de Compostela, 15706, Spain
| | - Laura García-Quintanilla
- Pharmacy Department, University Clinical Hospital of Santiago de Compostela (SERGAS), Santiago de Compostela, 15706, Spain.,Pharmacology Group, Health Research Institute of Santiago de Compostela (FIDIS), Santiago de Compostela, 15706, Spain
| | - Ana Castro-Balado
- Pharmacy Department, University Clinical Hospital of Santiago de Compostela (SERGAS), Santiago de Compostela, 15706, Spain.,Pharmacology Group, Health Research Institute of Santiago de Compostela (FIDIS), Santiago de Compostela, 15706, Spain
| | - Eva M Del Amo
- School of Pharmacy, Faculty of Health Sciences, University of Eastern Finland, Kuopio, 70211, Finland
| | - María Gil-Martínez
- Ophthalmology Department, University Clinical Hospital of Santiago de Compostela (SERGAS), Santiago de Compostela, 15706, Spain
| | - María José Blanco-Teijeiro
- Ophthalmology Department, University Clinical Hospital of Santiago de Compostela (SERGAS), Santiago de Compostela, 15706, Spain
| | - Miguel González-Barcia
- Pharmacy Department, University Clinical Hospital of Santiago de Compostela (SERGAS), Santiago de Compostela, 15706, Spain.,Pharmacology Group, Health Research Institute of Santiago de Compostela (FIDIS), Santiago de Compostela, 15706, Spain
| | - Irene Zarra-Ferro
- Pharmacy Department, University Clinical Hospital of Santiago de Compostela (SERGAS), Santiago de Compostela, 15706, Spain.,Pharmacology Group, Health Research Institute of Santiago de Compostela (FIDIS), Santiago de Compostela, 15706, Spain
| | - Anxo Fernández-Ferreiro
- Pharmacy Department, University Clinical Hospital of Santiago de Compostela (SERGAS), Santiago de Compostela, 15706, Spain.,Pharmacology Group, Health Research Institute of Santiago de Compostela (FIDIS), Santiago de Compostela, 15706, Spain
| | - Francisco J Otero-Espinar
- Department of Pharmacology, Pharmacy and Pharmaceutical Technology Faculty of Pharmacy, University of Santiago de Compostela (USC), Santiago de Compostela, 15782, Spain
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13
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Schulz A, Januschowski K, Szurman P. Novel vitreous substitutes: the next frontier in vitreoretinal surgery. Curr Opin Ophthalmol 2021; 32:288-293. [PMID: 33630788 DOI: 10.1097/icu.0000000000000745] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
PURPOSE OF REVIEW After removing the native vitreous during vitreoretinal surgery, an adequate substitute is required to ensure homeostasis of the eye. Current clinically used endotamponades (silicone oil, gases, semifluorinated alkanes) are effective in promoting retinal reattachment, but lead to complications such as emulsification, prolonged inflammation, blurred vision, raised intraocular pressure, cataract formation or the need for revision surgery. The aim of this review is to provide an update on novel vitreous substitutes with a focus on polymer-based systems. RECENT FINDINGS Polymeric hydrogels provide favourable properties such as high water content, optical transparency, suitable refractive indices and densities, adjustable rheological properties, injectability, biocompatibility and their ability to tamponade the retina via viscosity and swelling pressure, comparable to the native human vitreous body. Here, vitreous replacement strategies can be divided into chemically or physically crosslinked hydrogel systems that are applied as preformed or in-situ gelling matrices. SUMMARY Several hydrogel-based vitreous substitutes have already been positively evaluated in preclinical tests and have the potential to enter the clinical phase soon.
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Affiliation(s)
- André Schulz
- Eye Clinic Sulzbach, Knappschaft Hospital Saar
- Klaus Heimann Eye Research Institute, An der Klinik 10, Sulzbach
| | - Kai Januschowski
- Eye Clinic Sulzbach, Knappschaft Hospital Saar
- Klaus Heimann Eye Research Institute, An der Klinik 10, Sulzbach
- Centre for Ophthalmology, University Eye Hospital Tuebingen, Tuebingen, Germany
| | - Peter Szurman
- Eye Clinic Sulzbach, Knappschaft Hospital Saar
- Klaus Heimann Eye Research Institute, An der Klinik 10, Sulzbach
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14
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Thacker M, Tseng CL, Lin FH. Substitutes and Colloidal System for Vitreous Replacement and Drug Delivery: Recent Progress and Future Prospective. Polymers (Basel) 2020; 13:E121. [PMID: 33396863 PMCID: PMC7796247 DOI: 10.3390/polym13010121] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2020] [Revised: 12/18/2020] [Accepted: 12/19/2020] [Indexed: 01/10/2023] Open
Abstract
Vitreoretinal surgeries for ocular diseases such as complicated retinal detachment, diabetic retinopathy, macular holes and ocular trauma has led to the development of various tamponades over the years in search for an ideal vitreous substitute. Current clinically used tamponade agents such as air, perfluorocarbons, silicone oil and expansile gases serve only as a short-term solution and harbors various disadvantages. However, an ideal long-term substitute is yet to be discovered and recent research emphasizes on the potential of polymeric hydrogels as an ideal vitreous substitute. This review highlights the recent progress in the field of vitreous substitution. Suitability and adverse effects of various tamponade agents in present day clinical use and biomaterials in the experimental phase have been outlined and discussed. In addition, we introduced the anatomy and functions of the native vitreous body and the pathological conditions which require vitreous replacement.
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Affiliation(s)
- Minal Thacker
- Graduate Institute of Biomedical Engineering, National Taiwan University, Daan District, Taipei 10051, Taiwan;
| | - Ching-Li Tseng
- Graduate Institute of Biomedical Materials and Tissue Engineering, Taipei Medical University, Taipei 11031, Taiwan
| | - Feng-Huei Lin
- Graduate Institute of Biomedical Engineering, National Taiwan University, Daan District, Taipei 10051, Taiwan;
- Institute of Biomedical Engineering and Nanomedicine, National Health Research Institutes, Miaoli County 35053, Taiwan
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15
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Rossi T, Ripandelli G. Pars Plana Vitrectomy and the Risk of Ocular Hypertension and Glaucoma: Where Are We? J Clin Med 2020; 9:E3994. [PMID: 33321697 PMCID: PMC7763583 DOI: 10.3390/jcm9123994] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2020] [Revised: 11/30/2020] [Accepted: 12/08/2020] [Indexed: 01/16/2023] Open
Abstract
Purpose is to review the pathogenic mechanism for ocular hypertension and glaucoma development after pars plana vitrectomy. Both acute and chronic causes are considered, and special attention is paid to the theories and clinical evidence on the risk of developing Open Angle Glaucoma (OAG) after Pars Plana Vitrectomy (PPV). Most existing scientific literature on the issue agree on the role of ascorbate as an oxygen scavenger within the vitreous chamber. Oxygen tension in the vitreous and anterior chamber is maximum inn proximity of the retinal surface and endothelium, respectively and steeply decreases toward the lens, on both sides, and trabecular meshwork. Vitreous removal and, to a lesser extent, liquefaction, greatly reduces oxygen tension gradient in vitreous chamber while cataract extraction has similar effects on anterior chamber oxygen gradients. Oxygen derivatives originated from the cornea and retina are actively reduced by the vitreous gel and/or the crystalline lens. Vitreous removal and cataract extraction reduce drastically this function. Most reported clinical series confirm this hypothesis although protocol difference and follow-up length greatly impact the reliability of results.
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16
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Tram NK, Maxwell CJ, Swindle-Reilly KE. Macro- and Microscale Properties of the Vitreous Humor to Inform Substitute Design and Intravitreal Biotransport. Curr Eye Res 2020; 46:429-444. [PMID: 33040616 DOI: 10.1080/02713683.2020.1826977] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
Research on the vitreous humor and development of hydrogel vitreous substitutes have gained a rapid increase in interest within the past two decades. However, the properties of the vitreous humor and vitreous substitutes have yet to be consolidated. In this paper, the mechanical properties of the vitreous humor and hydrogel vitreous substitutes were systematically reviewed. The number of publications on the vitreous humor and vitreous substitutes over the years, as well as their respective testing conditions and testing techniques were analyzed. The mechanical properties of the human vitreous were found to be most similar to the vitreous of pigs and rabbits. The storage and loss moduli of the hydrogel vitreous substitutes developed were found to be orders of magnitude higher in comparison to the native human vitreous. However, the reported modulus for human vitreous, which was most commonly tested in vitro, has been hypothesized to be different in vivo. Future studies should focus on testing the mechanical properties of the vitreous in situ or in vivo. In addition to its mechanical properties, the vitreous humor has other biotransport mechanisms and biochemical functions that establish a redox balance and maintain an oxygen gradient inside the vitreous chamber to protect intraocular tissues from oxidative damage. Biomimetic hydrogel vitreous substitutes have the potential to provide ophthalmologists with additional avenues for treating and controlling vitreoretinal diseases while preventing complications after vitrectomy. Due to the proximity and interconnectedness of the vitreous humor to other ocular tissues, particularly the lens and the retina, more interest has been placed on understanding the properties of the vitreous humor in recent years. A better understanding of the properties of the vitreous humor will aid in improving the design of biomimetic vitreous substitutes and enhancing intravitreal biotransport.
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Affiliation(s)
- Nguyen K Tram
- Department of Biomedical Engineering, The Ohio State University, Columbus, OH, USA
| | - Courtney J Maxwell
- Department of Biomedical Engineering, The Ohio State University, Columbus, OH, USA
| | - Katelyn E Swindle-Reilly
- Department of Biomedical Engineering, The Ohio State University, Columbus, OH, USA.,William G. Lowrie Department of Chemical and Biomolecular Engineering, The Ohio State University, Columbus, OH, USA.,Department of Ophthalmology & Visual Science, The Ohio State University, Columbus, OH, USA
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