3D-printed long-acting 5-fluorouracil implant to prevent conjunctival fibrosis in glaucoma

J Pharm Pharmacol. 2023 Feb 8;75(2):276-286. doi: 10.1093/jpp/rgac100.

Abstract

Objectives: To develop a sustained release 5-fluorouracil (5-FU) implant by three-dimensional (3D) printing to effectively prevent conjunctival fibrosis after glaucoma surgery.

Methods: 3D-printed implants composed of polycaprolactone (PCL) and chitosan (CS) were fabricated by heat extrusion technology and loaded with 1% 5-FU. Light microscopy and scanning electron microscopy were used to study the surface morphology. The 5-FU concentration released over 8 weeks was measured by ultraviolet visible spectroscopy. The effects on cell viability, fibroblast contractility and the expression of key fibrotic genes were assessed in human conjunctival fibroblasts.

Key findings: The PCL-CS-5-FU implant sustainably released 5-FU over 8 weeks and the peak concentration was over 6.1 μg/ml during weeks 1 and 2. The implant had a smooth surface and its total weight decreased by 3.5% after 8 weeks. The PCL-CS-5-FU implant did not affect cell viability in conjunctival fibroblasts and sustainably suppressed fibroblast contractility and key fibrotic genes for 8 weeks.

Conclusions: The PCL-CS-5-FU implant was biocompatible and degradable with a significant effect in suppressing fibroblast contractility. The PCL-CS-5-FU implant could be used as a sustained release drug implant, replacing the need for repeated 5-FU injections in clinic, to prevent conjunctival fibrosis after glaucoma surgery.

Keywords: 3D printing; 5-FU; drug delivery; fibrosis; glaucoma; implant.

MeSH terms

  • Chitosan* / chemistry
  • Delayed-Action Preparations / chemistry
  • Fluorouracil / pharmacology
  • Glaucoma*
  • Humans
  • Printing, Three-Dimensional

Substances

  • Delayed-Action Preparations
  • Fluorouracil
  • Chitosan