Janus silk-based patch with temporary adhesion for inflammatory mediators removal in corneal alkali burn treatment

Corneal alkali burns cause persistent inflammation, leading to corneal vascularization and fibrosis, which severely impair vision. Here, we developed a temporary adhesive and detachable Janus silk-based patch to capture and remove inflammatory mediators from the ocular surface. The lower silk layer of the Janus patch incorporates of polyamidoamine and heparin, offering adsorption capacity for inflammatory mediators on the ocular surface. The upper hyaluronan layer imparts lubrication, alleviating foreign-body sensation and reducing shear stress from blinking. The integration of the silk and hyaluronan layers is achieved through interfacial diffusion, liquid-liquid phase separation, and photopolymerization, resulting in a stable interpenetrating network interface. After water annealing, the Janus patch exhibited excellent transparency, mechanical strength, and swelling resistance, remaining attached to the rat ocular surface for 3-5 days. Adsorption tests confirmed that the patch effectively captured small-molecule dyes, proteins, and free DNA. In the rat corneal alkali burn model, imaging and histological evaluations showed significant reductions in vascularization and fibrosis after 3 days of treatment, along with improved corneal transparency. RNA sequencing revealed that patch treatment effectively inhibited the PI3K-AKT inflammatory pathway. This inflammation-removing patch represents an innovative treatment for corneal alkali burns with significant clinical potential.