Enhanced therapeutic efficacy of cyclosporin A eluting hyaluronic acid contact lenses in the management of dry eye disease

PurposeCyclosporin A (CsA) delivery through contact lenses (CL) shows promise as a treatment for dry eye disease. Still, it faces obstacles like initial burst release, low drug loading capacity, and limited storage stability. To overcome these issues, we developed a hyaluronic acid-based contact lens (HA-CsA CL) to improve drug stability and sustain release. MethodsThe HA-CsA CL fabricated using aldehyde-hyaluronic and amine-hyaluronic acid via thermal polymerization were evaluated for in vitro CsA release, optical clarity, oxygen permeability and storage stability. Safety was assessed through Bovine Corneal Opacity and Permeability (BCOP) and cytotoxicity assays. At the same time, efficacy in treating dry eye disease was tested in an animal disease model by measuring tear volume, tear film break-up time (TBUT), and corneal fluorescein staining (CFS) over 14 days. ResultsUnder physiological conditions, the CL continuously released CsA over 24 h and retained stability for 60 days at pH 5.5 and 4 degrees C. Optical transmittance and oxygen permeability of the CL remained within normal ranges, with no evidence of toxicity or ocular irritation. In vivo studies revealed significant improvements in tear volume, TBUT, CFS, corneal apoptotic cell counts, and conjunctival goblet cell density in the HA-CsA CL group compared to controls (p < 0.05). ConclusionThe developed HA-CsA CL effectively controlled the release of CsA, minimized the initial burst release, enhanced drug stability, and exhibited significant therapeutic efficacy in alleviating dry eye symptoms without causing ocular irritation or toxicity.