Advances in ophthalmic drug delivery technology for postoperative management after cataract surgery

ABSTRACT

Introduction

Cataract surgery is becoming more common due to an aging world population. Intraocular lenses and surgical technique have developed remarkably recently, but the development of postoperative medication to prevent postsurgery complications has been relatively delayed. We still largely depend on eye drops for the management of post-cataract-surgery patients. Mental and physical problems that often occur in elderly cataract patients make it difficult for patients to apply eye drops by themselves. It is necessary to develop new effective drug delivery methods.

Areas covered

This updated review article provides a brief review of why drug management is needed following cataract surgery and an overview of current developments in new drug delivery methods for ophthalmic treatment. In particular, various novel drug delivery methods that can be used for post-cataract-surgery management and their current development stages are extensively reviewed.

Expert opinion

Rapidly developing technologies, such as intraocular and external ophthalmic implants, polymers, and nanotechnology, are being actively applied to develop novel drug delivery systems for safe and effective management after cataract surgery. Their goal is to achieve sufficient drug release for the desired duration with a single application. These will largely replace the inconvenience of eye drops for elderly patients in the future.

KEYWORDS:

• Antibiotic
• cataract
• drug
• implant
• nanotechnology
• polymer
• steroid
• surgery

Article highlights

• The surgical volume of cataract surgery will increase further in the future due to a global aging of the population.

• Drug management is essential after cataract surgery to prevent complications, such as bacterial infection and inflammation.

• A significant portion of elderly patients find it difficult to follow the regular instillation of eye drops, which is necessary for post-cataract-surgery management.

• The mechanical and anatomic barrier of the eye against topically applied medication limits the effectiveness of conventional eyedrop treatment.

• It is necessary to develop drug delivery systems that can effectively and safely release drugs for a period of two weeks or more, performing postoperative drug management with a single application after surgery.

• Extraocular drug delivery systems using punctal plugs, contact lenses, or ocular rings are being developed for antibiotic or anti-inflammatory drug delivery after cataract surgery.

• With the development of polymer technology, various hydrogels are being developed as extraocular and intraocular drug delivery devices.

• In order to bypass the intrinsic ocular drug barrier, an intraocular drug implant is expected to have the best effect at present. These are manufactured with a polymer and drug complex, and sometimes in the form of binding to an intraocular lens.

• Attempts to use an intraocular lens implanted in cataract surgery as a drug delivery device are very promising.

• A variety of nanotechnologies are being used to develop drug delivery methods after cataract surgery. They can become drug carriers or can be combined with polymer technology to overcome the intrinsic ocular barrier against drugs.

Declaration of interest

The authors have no relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript. This includes employment, consultancies, honoraria, stock ownership or options, expert testimony, grants or patents received or pending, or royalties.

Reviewer disclosures

Peer reviewers on this manuscript have no relevant financial or other relationships to disclose.

Additional information

Funding

This work was supported in by the National Research Foundation of Korea (NRF) funded by the Ministry of Education (Grant number: NRF-2020R1F1A1068201 and NRF-2021R1A2C1006087).