Development of next-generation Intraocular lens combined with degradable drug delivery system toward prevention of Posterior Capsule Opacification

白内障是一种眼科疾病，正常的透明眼晶状体变得混浊或混浊，导致视力下降。眼镜片负责聚焦光线，并在眼后的视网膜上产生清晰的图像。白内障通常是一个健康老龄化的持续过程，但很少会迅速发展。白内障占全球失明人数的51%以上。2010年，世界卫生组织估计有2000万人患有白内障，患病率估计将翻一番，2020年达到4000万。在美国，每年有300多万例白内障手术。老年性白内障的患病率随着年龄的增长而增加；在美国，白内障患者的平均年龄约为68岁，在中国和英国分别为50岁和65岁。白内障的治疗方法是用人工晶状体取代自然混浊的晶状体。在手术过程中，新的晶状体被插入剩余的晶状体囊中，容纳新的晶状体，恢复视力。不幸的是，由于称为后囊混浊(PCO)的伤口愈合反应，相当一部分患者会发生继发性失明，也称为“继发性白内障”。目前，后囊混浊最常见和最有效的治疗方法是激光囊膜切开术，这种手术的目的是在囊袋上开一个洞，让光线再次通过。然而，这有许多有害的副作用，而且对医疗保健提供者来说也很昂贵。为了减少白内障手术的并发症，自1952年哈罗德·里德利首次开发人工晶状体以来，人们对其进行了广泛的改进。新的镜片设计有助于减少后囊混浊进展的影响，但预防后囊混浊仍然难以捉摸。透镜制造公司和研究学者正在不断寻找新的设计和材料来解决PCO。这项建议的总体目标是开发新的镜片，以恢复白内障手术后的高质量视力，并防止后发性白内障的形成。这项研究将释放新透镜设计的潜力，将新兴的3D打印技术作为一种新的制造工具。与现有方法相比，这将有几个优点。3D打印方法提供了新镜片的快速原型开发，并将镜片开发的生命周期缩短了数周，从而加快了产品开发，因此镜片可以更快地到达患者手中。还有可能解锁用标准方法无法生产的新设计。这些可能会改善手术的结果。该提案还开发了一种药物输送系统，以针对手术后发生的炎症。该输送系统将实现按需受控输送药物。综上所述，新的镜片设计，加上局部给药，为治疗白内障和预防白内障并发症提供了潜在的新疗法。这项建议将由阿拉姆·赛义德博士领导，他是药物输送、聚合物化学和医疗器械开发方面的专家，与世界领先的白内障和后囊膜疾病专家迈克尔·沃姆斯通教授合作。

A cataract is an ophthalmic disease in which a normal clear eye lens becomes cloudy or opaque, leading to a decrease in vision. The eye lens is responsible for focusing light and producing a clear image on the retina at the back of the eye. Cataracts are typically an ongoing process of healthy ageing, but seldom develop rapidly. Cataracts are responsible for more than 51% of the world's blindness. In 2010, the WHO estimated that 20 million people were suffering from cataracts and that the prevalence is estimated to double, reaching 40 million in 2020. There are more than three million cataract surgeries performed in the US annually. The prevalence of age-related cataract increases with age; the average age of a cataract patient is approximately 68 years in the US, and 50 and 65 in China and the UK, respectively.Cataracts are treated surgically by replacing the natural clouded lens with an artificial lens. During the procedure, the new lens is inserted into the remaining capsule, housing the new lens, and restoring visual acuity. Unfortunately, secondary blindness, also termed "secondary cataract" develops in a significant proportion of patients due to a wound-healing response known as posterior capsule opacification (PCO). Presently, the most common and effective treatment of PCO is laser capsulotomy, a procedure aimed to create a hole in the capsular bag to allow light to pass through again. However, this has many deleterious side effects and is also expensive for healthcare providers.To reduce the complication of cataract surgery, artificial lenses have been extensively modified since they were first developed in 1952 by Harold Ridley. The new lens designs have helped reduce the impact of PCO progression, but prevention of PCO remains elusive. Lens manufacturing companies and research academics are continuously searching for new designs and materials to address PCO. The overall aim of this proposal is to develop new lenses to restore high-quality vision following cataract surgery and prevent PCO formation. This research will unlock the potential of new lens design using emerging 3D printing technology as a new fabrication tool. This will have several advantages over the existing methods. The 3D printing method provides rapid prototype development of new lenses and takes weeks off the life cycle of lens development, expediting product development so lenses can reach patients quicker. There is also the potential to unlock new designs that would be impossible to produce by standard methods. These could potentially better the outcome of the surgery. This proposal also develops a drug delivery system to target the inflammation that occurs following surgery. The delivery system will enable controlled delivery of the drugs on-demand. Taken together, the new lens design, with local delivery of drugs, presents potential new therapies to treat cataract and prevent cataract complication. This proposal will be led by Dr Aram Saeed who is an expert in drug delivery, polymer chemistry and development of medical devices, in collaboration with Prof Michael Wormstone, a world-leading expert in cataract and the PCO condition.