Nanofiber-based glaucoma drainage implant improves surgical outcomes by modulating fibroblast behavior

Area of Science:

• Biomaterials Science
• Ophthalmology
• Tissue Engineering

Background:

• Biomaterial implants often trigger fibrotic encapsulation, limiting their effectiveness and lifespan.
• Glaucoma drainage implants (GDIs) are crucial for reducing intraocular pressure (IOP) but suffer from high failure rates due to fibrosis.
• Current GDIs face challenges with fibrosis and surgical success, necessitating improved designs.

Purpose of the Study:

• To develop and evaluate novel synthetic, nanofiber-based GDIs with partially degradable cores.
• To investigate the impact of surface topography (nanofiber vs. smooth) on GDI performance and foreign body response.
• To assess the biocompatibility, efficacy, and antifibrotic properties of the developed nanofiber GDIs in an animal model.

Main Methods:

• Fabrication of synthetic GDIs with nanofiber or smooth surfaces and partially degradable cores.
• In vitro assessment of fibroblast behavior on different GDI surface topographies under pro-fibrotic conditions.
• In vivo evaluation of nanofiber GDIs in rabbit eyes, assessing biocompatibility, IOP, aqueous humor outflow, and fibrotic markers.

Main Results:

• In vitro studies showed nanofiber surfaces promoted fibroblast quiescence compared to smooth surfaces.
• In rabbit eyes, nanofiber GDIs demonstrated biocompatibility and comparable aqueous humor outflow to commercial GDIs.
• Nanofiber GDIs exhibited significantly reduced fibrotic encapsulation and expression of fibrotic markers compared to controls.

Conclusions:

• Nanofiber surface topography on GDIs mitigates fibroblast activation and reduces fibrotic encapsulation.
• The developed nanofiber GDIs show promise for improved biocompatibility and extended functional lifespan.
• Mimicking natural extracellular matrix structure with biomaterials can enhance implant performance in ophthalmology.