Dynamic regulation of thermal-responsive fibers for mitomycin C-controlled delivery on glaucoma drainage device implantation.

Bleb fibrosis remains the most common reason for glaucoma surgery failure. Although mitomycin C (MMC) is often used to inhibit fibrosis during glaucoma drainage device (GDD) implantation, the effective reaction time of anti-fibrosis could not cover the dynamic process of wound healing. To enable noninvasive dynamic ocular drug release, we fabricated MMC-loaded thermos-responsive fiber membranes using polylactic acid (PLA) and tributyl citrate as a plasticizer. The fibers exhibited a transition temperature of 41.5 °C. To regulate drug delivery, the fiber was first stretched, coated on the GDD surface, and then implanted in rabbit eyes. The thermal-responsive fiber recovered to its original morphology upon exposure to a 43 °C stimulus in filtering bleb area one week postoperatively. The release profiles in vitro were described best by the first-order kinetics. The release rate constants were korigin = 0.11 ± 0.01 day-1 and kstretched = 0.09 ± 0.02 day-1, respectively. The controlled release system effectively reduced the bleb fibrosis in rabbit conjunctiva. This MMC-controlled delivery system successfully inhibited scarring after GDD implantation surgery.