Preparation of Thermosensitive Anti-inflammatory Lacrimal Plugs and Observation of Their Effects in Dry Eye Treatment
Journal: Journal of Clinical Medicine Research DOI: 10.32629/jcmr.v5i3.2794
Abstract
This study aims to develop a novel thermosensitive lacrimal plug material to address current challenges in dry eye treatment. We prepared thermosensitive lacrimal plugs using N-isopropylacrylamide (NIPAM) hydrogel, loaded with dexamethasone and mitomycin C to impart anti-inflammatory and anti-fibrotic properties to the material. Rheological tests demonstrated that the material exhibits good fluidity at room temperature, facilitating injection and implantation, while rapidly solidifying at body temperature to form a stable structure. Differential Scanning Calorimetry (DSC) determined the lower critical solution temperature (LCST) to be approximately 31.3°C, confirming the material's thermosensitive characteristics. In a New Zealand white rabbit dry eye model, tear secretion in the experimental group significantly increased from 15.00 mm post-modeling to 20.75 mm after 7 days of treatment following thermosensitive lacrimal plug implantation (p<0.01). Histopathological analysis revealed a marked increase in conjunctival goblet cell count in the treatment group, further validating the therapeutic effect. The results indicate that this thermosensitive NIPAM lacrimal plug material demonstrates significant efficacy in improving tear secretion and promoting tissue repair. Its unique thermosensitive properties help address individual adaptability issues, while the drug-loading capability provides anti-inflammatory effects. This novel lacrimal plug presents an intriguing research direction for dry eye treatment, though further studies are needed to evaluate its safety and efficacy in clinical applications.
Keywords
dry eye syndrome; thermosensitive lacrimal plug; N-isopropylacrylamide; anti-inflammatory; personalized treatment
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[3]Dai M, Xu K, Xiao D, Zheng Y, Zheng Q, Shen J, Qian Y, Chen W. In Situ Forming Hydrogel as a Tracer and Degradable Lacrimal Plug for Dry Eye Treatment. Adv Healthc Mater. 2022 Oct;11(19):e2200678. doi: 10.1002/adhm.202200678.
[4]Yellepeddi VK, Sheshala R, McMillan H, Gujral C, Jones D, Raghu Raj Singh T. Punctal plug: a medical device to treat dry eye syndrome and for sustained drug delivery to the eye. Drug Discov Today. 2015 Jul;20(7):884-9. doi: 10.1016/j.drudis.2015.01.013.
[5]Zhang Jinying, Li Xueqin. Advances in the Interventional Treatment of Lacrimal Duct Obstruction [J]. Journal of Clinical Ophthalmology, 2002, 10(2): 191-192.
[6]Zhu M, Wang J, Li N. A novel thermo-sensitive hydrogel-based on poly(N-isopropylacrylamide)/hyaluronic acid of ketoconazole for ophthalmic delivery. Artif Cells Nanomed Biotechnol. 2018 Sep;46(6):1282-1287. doi: 10.1080/21691401.2017.1368024.
[7]Tost FHW, Geerling G. Plugs for occlusion of the lacrimal drainage system. Dev Ophthalmol. 2008;41:193-212. doi: 10.1159/000131090.
[8]Brissette AR, Mednick ZD, Schweitzer KD, Bona MD, Baxter SA. Punctal Plug Retention Rates for the Treatment of Moderate to Severe Dry Eye: A Randomized, Double-Masked, Controlled Clinical Trial. Am J Ophthalmol. 2015 Aug;160(2):238-242.e1. doi: 10.1016/j.ajo.
[9]Li Xueming, Zhang Jun, Wang Wei. Clinical Efficacy of Lacrimal Duct Occlusion Surgery in the Treatment of Dry Eye Syndrome [J]. Chinese Journal of Ophthalmology, 2005, 41(12): 1098-1102. DOI: 10.3760/j:issn:0412-4081.2005.12.009.
[10]Burgess PI, Koay P, Clark P. SmartPlug versus silicone punctal plug therapy for dry eye: a prospective randomized trial. Cornea. 2008 May;27(4):391-4. doi: 10.1097/ICO.0b013e318160d030.
[11]Tost FHW, Geerling G. Plugs for occlusion of the lacrimal drainage system. Dev Ophthalmol. 2008;41:193-212. doi: 10.1159/000131090.
[12]Best AL, Labetoulle M, Legrand M, M'garrech M, Barreau E, Rousseau A. Punctal and canalicular plugs: Indications, efficacy and safety. J Fr Ophtalmol. 2019 Mar;42(3):e95-e104. doi: 10.1016/j.jfo.2018.12.003.
[13]Khanna T, Akkara JD, Bawa V, Sargunam EA. Designing and making an open source, 3D-printed, punctal plug with drug delivery system. Indian J Ophthalmol. 2023 Jan;71(1):297-299. doi: 10.4103/ijo.IJO_997_22.
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