A Dexamethasone-Loaded Compact Intraocular Lens for Cataract Surgery: Validation in an in Vivo Pilot Study

Intraocular lens (IOL) implantation is widely performed, but poor adherence to traditional eye drop therapy and low drug bioavailability increase the risk of postoperative inflammation and infection. Although many drug delivery strategies have been proposed, in vivo evidence is limited, and scalability remains a key challenge for clinical use. In this study, we introduce a compact dexamethasone (DXM)-loaded IOL fabricated through a simple, low-cost, one-step process by embedding DXM within a biocompatible polydimethylsiloxane (PDMS)-based polymer matrix. The DXM-loaded IOL was evaluated in in vitro assays and in seven New Zealand-California White rabbits undergoing cataract surgery, with the DXM-loaded IOL implanted in the right eye and a nonloaded IOL used as a control in the left eye. Aqueous humor samples were collected at different time points to assess prostaglandin E2 (PGE2) levels as an inflammatory biomarker, as well as DXM release. Drug release ranged from 31% to 99% (2.1-8.5 μg), and PGE2 levels were lower in eyes implanted with the DXM-loaded IOL than in control eyes, indicating reduced inflammation. In conclusion, we present a preclinical validated prototype of a dual-function IOL that maintains visual performance and reduces postoperative inflammation.