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    The dexamethasone nanowafer: A novel method of drug delivery for dry eye disease

    New dexamethasone nanowafer enhances corticosteroid diffusion into the cornea and maintains a smooth, healthy corneal surface with intact barrier function

    Take-home message: This review presents a therapeutic nanowafer as an alternative to eye drops for dry eye disease, designed to enhance efficacy and improve patient compliance to treatment. In an experimental animal study, the novel dexamethasone nanowafer drug delivery system was comparable in efficacy to twice-daily dexamethasone eye drop treatment and has the potential to minimise risk of cataract formation and glaucoma.

     

    Dry eye affects millions of people worldwide and is fast becoming a major public health problem.1,2 Dry eye has a number of causes, including ocular inflammation, hormonal imbalance and aging. Increasing use of visual displays in computers and mobile devices, contact lenses and LASIK surgery can further deteriorate the dry eye condition.3-6  

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    Presently, mild dry eye is treated with artificial tear eye drop to hydrate the ocular surface. Such artificial tears provide temporary relief for the patient. Chronic dry eye, which is associated with ocular inflammation, is treated with topical anti-inflammatory corticosteroid or cyclosporine-A eye drops. Although eye drops provide the simplest mode of treatment, therapeutic efficacy and patient compliance are far less than optimal, which is primarily due to rapid clearance of the eye drops by reflex tearing, blinking and nasolacrimal drainage.7,8 Although nanoparticle ophthalmic formulations and drug-loaded contact lenses have been developed to treat dry eye, their efficacy in delivering therapeutically effective drug concentrations to tissues in the anterior segment of the eye, such as cornea and conjunctiva, remains very inefficient.9-11 Together, these limitations have created an unmet need for the development of a drug deliver system that boasts extended release attributes along with an enhanced efficacy to treat dry eye disease.

    A novel method of drug delivery

    To enhance therapeutic efficacy and improve the patient compliance, a novel nanowafer drug delivery system, the dexamethasone-nanowafer (Dex-NW), has been developed and tested in an experimental mouse dry eye model.12 Designed to restore corneal smoothness and barrier function via the slow release of dexamethasone, the nanowafer is a tiny disc-like membrane that contains drug-loaded nano-reservoirs. It is simply applied on the ocular surface using the fingertips, like a contact lens. During the course of the drug release, the nanowafer dissolves completely.

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    In the experimental mouse-model study, hydrogel-forming carboxymethyl cellulose (CMC) polymer was chosen for the nanowafer fabrication. This material was deemed the best choice due to its water solubility, mucoadhesiveness, and current clinical use as an active ingredient in artificial tear eye drops.13,14

    Next: Study outcome measurements

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