Changing Ocular Delivery Paradigms

随着人口老龄化和生活方式因素的增加，眼科疾病已经成为加拿大人健康的重大负担。据估计，每年的成本超过150亿美元，视力障碍影响的加拿大人比乳腺癌、前列腺癌、阿尔茨海默氏症和帕金森氏症加起来还要多。此外，视力受损的患者患抑郁症的几率更高，入住养老院的时间更早，摔倒的频率更高，死亡的年龄比有视力的人年轻得多。然而，随着新疗法的发展，需要克服传统给药方法的局限性。基于材料的解决方案具有克服其中许多限制的巨大潜力。虽然生物材料在眼睛中的使用历史很长，主要是作为隐形眼镜和人工晶状体，但在眼科应用中仍有机会改进使用的材料，这既可以增加患者的舒适度和便利性，也可以提高治疗效果。所描述的研究计划旨在开发基于材料的新型眼科治疗方法，包括针对眼睛前后的新型药物输送装置和新型隐形眼镜材料。眼部给药系统旨在利用泪膜的自然解剖特征，以延长药物在眼睛上的滞留时间，同时利用眼药水的可接受性。虽然注射是治疗眼后部疾病的常规方法，但治疗的频率对医生和患者都不方便，而且每次眼睛破裂都有很大的并发症风险。原位凝胶系统将使注射的频率大大降低，将这些风险降至最低。最后，新的隐形眼镜表面具有更好的润湿性和更低的摩擦力，将把不适降至最低，并降低并发症的风险。最终，新的眼科材料将为日益增长的视力受损人群提供更好的视觉效果和更丰富的生活。

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.