Changing Ocular Delivery Paradigms

随着人口老龄化和生活方式因素的增加，眼部疾病已成为加拿大人健康的重大负担。 据估计，加拿大人每年因视力障碍而遭受的损失超过150 B美元，超过了乳腺癌、前列腺癌、老年痴呆症和帕金森病的总和。 此外，视力受损患者抑郁症的发病率增加，更早进入疗养院，更经常摔倒，并且比视力正常的人口死亡年龄小得多。 然而，随着新疗法开发的进展，需要克服传统递送方法的局限性。 基于材料的解决方案有很大的潜力来克服这些限制。 虽然生物材料在眼睛中的使用历史很长，主要是作为接触镜和人工晶状体，但仍有机会改进眼科应用中使用的材料，以提高患者的舒适度和便利性，并提高治疗效果。 所描述的研究计划旨在开发基于新材料的眼部治疗，包括针对眼睛前部和后部的新药物输送装置和新接触透镜材料。 眼前给药系统旨在利用泪膜的天然解剖学特征，以延长药物在眼睛上的停留时间，同时利用滴眼剂的可接受性。 虽然注射通常用于治疗眼睛后部的疾病，但是治疗的频率对于医生和患者都是不方便的，并且眼睛的每次破裂都伴随着严重的并发症风险。 原位胶凝系统将使注射的频率低得多，从而将这些风险降至最低。 最后，具有改善的润湿性和较低摩擦的新接触透镜表面将最大限度地减少不适并降低并发症的风险。 最终，新型眼用材料将为日益增长的视力受损人群提供更好的视力结果和更丰富的生活。

With the aging population and increasing lifestyle factors, diseases of the eye have become significant burdens to the health of Canadians. With an estimated cost of more than $15 B annually, vision impairment affects more Canadians than breast cancer, prostate cancer, Alzheimers and Parkinson's disease combined. Furthermore, vision impaired patients have increased incidences of depression, are admitted to nursing homes earlier, fall more often and die at a significantly younger age than the sighted population. With advances in the development of new therapeutics, there is however a need overcome limitations to traditional methods of delivery. Materials-based solutions have a great potential to overcome many of these limitations. While biomaterials have a long history of use in the eye, mainly as contact lenses and intraocular lenses, there are opportunities to improve materials used in ophthalmic applications, both to increase patient comfort and convenience and improve the efficacy of the treatment. The research program described is aimed at the development of novel materials-based ocular treatments, including new drug delivery devices targeting front and back of the eye and new contact lens materials. Front of the eye delivery systems are designed to take advantage of the natural anatomical features of the tear film in order to prolong the residence time of the drug on the eye while capitalizing on the acceptability of eyedrops. While injections are routinely used to treat diseases of the back of the eye, the frequency of the treatments is inconvenient for both the physician and the patient and each breach of the eye carries with it a significant risk of complication. In situ gelling systems will allow the injections to be performed much less frequently, minimizing these risks. Finally, new contact lens surfaces with improved wettability and lower friction will minimize discomfort and decrease the risk of complications. Ultimately, novel ocular materials will allow for better visual outcomes and richer lives for the growing visually compromised population.