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Ze Zhang, Diane Blake, Nurettin Sahiner, Ramesh Ayyala; Slow release antibiotic medication delivery system in an animal model of ophthalmic surgery. Invest. Ophthalmol. Vis. Sci. 2021;62(8):1185.
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© ARVO (1962-2015); The Authors (2016-present)
The most common ophthalmic surgery performed in the world is cataract surgery, as cataracts affect the aging population and is an inevitable part of life. Standard post-operative care after all ophthalmic surgery involve the use of eye drops to prevent infection. One of the major challenges including the postoperative infection prevention after ophthalmic surgery is the difficulty in administering topical medications into the patients’ eyes. Studies have shown that up to 50% of prescribed drops are incorrectly instilled or not used at all. When used correctly, only a minor fraction of the instilled medication can effectively get into eyes. In this study, we examine the safety and efficacy of an in vitro safe sustained release formulation of antibiotics in prevention and treatment of ocular infections. This could revolutionize infection control and treatment regimens, and significantly improve patient’s outcomes and quality of life, while also reducing the cost of care.
Hyaluronic acid conjugated polymers of ciprofloxacin and vancomycin were created using biocompatible chemical linkers with stable release profile and safety in vitro. 10,000 colony forming units of bacteria were injected into the anterior chamber of New Zealand white rabbit eyes to simulate potential inoculation from bacteria during surgery and compared to standard topical antibiotic therapy using ciprofloxacin and vancomycin. Daily clinical anterior segment and fundus exams were performed. Animals were followed daily for 2 weeks or until any evidence of endophthalmitis.
Hyaluronic acid-antibiotic polymers provide effective prophylaxis and treatment of potential bacterial inoculation of Staphylococcus aureus and Pseudomonas aeruginosa in a rabbit model for ophthalmic surgery that is non-inferior to current standard of care using topical antibiotics. Rabbit eyes are able to clear the infection at similar rates in both groups.
The hyaluronic acid and antibiotic polymers provide effective and predicable release of antibiotics that are safe and effective in vitro and in vivo. These particles provide a novel way to deliver drugs in an ophthalmic setting that could replace the need for post-operative drops and make surgery dropless. These sustained release particles could also be used to treat corneal keratitis, removing the need for hourly drops, improving both efficacy and patient quality of life.
This is a 2021 ARVO Annual Meeting abstract.
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