Eibl-Lindner K H, Wertheimer C, Kampik A
Augenklinik, Klinikum der Universität München.
Klin Monbl Augenheilkd. 2016 Feb;233(2):172-8. doi: 10.1055/s-0041-109512. Epub 2016 Feb 15.
Development of an intraocular lens (IOL) as a drug delivery device has been pursued for many years and is a promising concept in modern cataract surgery. Common postoperative conditions such as posterior capsule opacification (PCO), intraocular inflammation or the rare but severe complications of cataract surgery like endophthalmitis are potential therapeutic targets for a drug-eluting IOL. There are three techniques of pharmacological IOL modification: Firstly, surface modification of the IOL ("coating"); secondly, IOL optic modification ("soaking") and lastly, loading the IOL haptics with a slow release system. The last option does not interfere with the IOL optics at all. Therefore, a broad spectrum of pharmacological agents needs to be assessed in preclinical and clinical studies to determine which agent/IOL combination is safe and efficient. For pharmacological PCO prophylaxis, erufosine-loaded IOLs are of great clinical interest. Heparin-coated IOLs might become clinically relevant for attenuation of intraocular inflammation after cataract surgery and cefuroxime-loaded IOLs for endophthalmitis prophylaxis.
将人工晶状体(IOL)开发为药物递送装置的研究已进行多年,这在现代白内障手术中是一个很有前景的概念。诸如后囊膜混浊(PCO)、眼内炎症等常见的术后情况,或白内障手术中罕见但严重的并发症如眼内炎,都是药物洗脱人工晶状体潜在的治疗靶点。有三种药物修饰人工晶状体的技术:第一,人工晶状体的表面修饰(“涂层”);第二,人工晶状体光学部修饰(“浸泡”);最后,在人工晶状体襻上加载缓释系统。最后一种选择完全不会干扰人工晶状体的光学性能。因此,需要在临床前和临床研究中评估多种药理剂,以确定哪种药剂/人工晶状体组合是安全有效的。对于药物性预防PCO,载有厄鲁福新的人工晶状体具有极大的临床研究价值。肝素涂层人工晶状体可能在临床上对减轻白内障手术后的眼内炎症具有相关性,而载有头孢呋辛的人工晶状体则用于预防眼内炎。