Lacrimal Drainage Catheter Coated with Mitomycin C to Inhibit Fibrosis after Canalicular Laceration Repair

Canalicular lacerations represent a common ocular emergency that can lead to significant complications if not managed promptly and effectively. Silicone stents are the most commonly chosen option due to their favorable characteristics. However, postoperative complications, such as canalicular stenosis, remain prevalent, necessitating the exploration of additional therapeutic strategies. Mitomycin C (MMC) is an effective agent for preventing excessive fibrosis in various ophthalmic surgeries; however, its topical application faces challenges due to rapid clearance and potential side effects. Currently, we have established a dual-layer drug delivery system for MMC, wherein lacrimal drainage catheters (LDC) were coated with agarose loaded with MMC (MA-1, MA-2, and MA-3) and subsequently encapsulated in a layer of poly-(lactic-co-glycolic acid) (PLGA). The LDC@MA-1@PLGA, LDC@MA-2@PLGA, and LDC@MA-3@PLGA released final amounts of MMC of 1.72 ± 0.21 μg, 5.32 ± 0.56 μg, and 9.32 ± 0.16 μg during the first 8 days, with corresponding final release rates of 57.43 ± 7.78%, 85.36 ± 10.49%, and 79.06 ± 2.56%, respectively. In vitro assays demonstrated that MMC not only inhibits fibroblast proliferation but also enhances apoptosis, particularly in the fibrotic context induced by TGF-β1. Additionally, in vivo experiments demonstrated that LDC@MA@PLGA effectively reduced the expression levels of α-SMA and collagen deposition. Overall, the findings from our study elucidate the potential of LDC@MA@PLGA as an effective therapeutic strategy in preventing postsurgical fibrosis following canalicular laceration repairs.