Near-infrared light-responsive implantable module integrated into glaucoma drainage device for controlled antifibrotic drug therapy

초록

Unmodulated postoperative fibrosis remains a major barrier to the long-term success of glaucoma drainage devices (GDDs) because excessive fibrotic encapsulation obstructs aqueous humor outflow and ultimately leads to device failure. Current antifibrotic therapies rely on topical or injectable steroids, but their limited ocular bioavailability, procedural invasiveness, and inability to support patient-specific dosing restrict long-term effectiveness. To address these limitations, this study introduces an implantable near-infrared (NIR) light-responsive module (NRM), compact enough for integration into a GDD (NRM-GDD), that enables noninvasive, on-demand, and dose-controlled delivery of dexamethasone as an antifibrotic agent. The NRM incorporates a poly(lactic-co-glycolic acid) (PLGA) drug depot and an indocyanine green (ICG) photothermal layer, allowing NIR-induced temperature elevation and softening of the polymer matrix to increase drug release in an ondemand manner while maintaining tissue-safe temperatures. When implanted in rabbit eyes, the NRM-GDD markedly reduces fibrotic capsule thickness, collagen deposition, and inflammatory cell infiltration in proportion to the number of NIR irradiations without inducing adverse ocular effects. These findings demonstrate a clinically translatable strategy for programmable postoperative delivery of an antifibrotic agent using GDDs and underscore the broader applicability of NIR light-responsive implantable drug delivery modules across diverse implantable platforms.

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