Antibacterial Bionic Surface on Intraocular Lenses to Prevent PCO and Endophthalmitis Through Surface-Initiated RAFT Polymerization

Antifouling and antibacterial intraocular lenses (IOLs) are required to lower the incidence of posterior capsule opacification (PCO) and postoperative endophthalmitis. Bionic zwitterionic polymer such as 2-methacryloyloxyethyl phosphorylcholine (MPC) shows excellent biocompatibility and strong ability to resist nonspecific proteins and bacterial adhesion. In this work, a novel bionic brushes coating containing MPC and N, N, N-trimethyl-2-((4-(2-(4-nonylphenoxy) ethoxy)-4-oxobut-2-enoyl) oxy) ethan-1-aminium chloride (TOEAC), a quaternary ammonium monomer, was prepared onto IOLs using reversible addition-fragmentation chain transfer (RAFT) polymerization method. The success of surface modification was investigated by spectroscopic ellipsometry, water contact angle, Fourier transform infrared spectroscopy, and X-ray photoelectron spectroscopy. The P(TOEAC-co-MPC) brushes functionalized IOL exhibited excellent antifouling efficiency against bovine serum albumin, Staphylococcus aureus, and human lens epithelial cells. In addition, the P(TOEAC-co-MPC) brushes showed excellent antibacterial and antibiofilm abilities and good biocompatibility. Anin vivo study confirmed that the P(TOEAC-co-MPC) brushes effectively prevented PCO and endophthalmitis. Consequently, the P(TOEAC-co-MPC) bionic brushes are promising for IOLs surface modification to resist postoperative complications for long-term implantation.