Cascade catalytic multilayer modified intraocular lens for enhanced and safer posterior capsule opacification prevention.

Posterior capsule opacification (PCO) is the most common complication after cataract surgery. It is primarily caused by the proliferation, migration, and adhesion of residual lens epithelial cells within the capsular bag following phacoemulsification and intraocular lens (IOL) implantation. Although investigations of surface modification onto IOL have partially reduced PCO development in recent years, there are still challenges in long-term efficacy and intraocular biocompatibility. In this study, a cascade catalytic system is constructed using natural enzymes onto mesoporous silica nanoparticles (MSNs), which are subsequently fixed to the surface of IOL through layer-by-layer self-assemble of alternating positive and negative charges. The cascade catalytic reaction is trigged simply by glucose within the pouch to produce reactive oxygen species (ROS) without introducing any toxic drugs or external energy, attempting to minimize the possible toxic side effects to surrounding tissues. In vivo and in vitro experiments indicate the effective inhibition of PCO and favorable intraocular compatibility of the cascade catalytic platform modified IOL. More importantly, the modified IOL retains good optical performance and imaging quality, demonstrating promising prospects for application. This study provides a new possibility for enhanced and safer PCO prevention, playing great significance in clinical treatment. STATEMENT OF SIGNIFICANCE: Cascade catalytic nanoparticles-loaded multilayer modified IOL is obtained via LbL technique. The multilayer coating improves both the loading capacity and the activity of the cascade catalytic nanoparticles. The cascade catalytic reaction is trigged by glucose, producing ROS that efficiently induces apoptosis and death of remaining cells on IOL without introducing any toxic drugs or external energy. The innovative IOL provides a promising approach for enhanced and safer prevention of PCO.