Development of Absorbable, Antibiotic-Eluting Sutures for Ophthalmic Surgery

Fabiana Kashiwabuchi; Kunal S Parikh; Revaz Omiadze; Shuming Zhang; Lixia Luo; Himatkumar V Patel; Qingguo Xu; Laura M Ensign; Hai-Quan Mao; Justin Hanes; Peter J McDonnell

doi:10.1167/tvst.6.1.1

Development of Absorbable, Antibiotic-Eluting Sutures for Ophthalmic Surgery

Transl Vis Sci Technol. 2017 Jan 3;6(1):1. doi: 10.1167/tvst.6.1.1. eCollection 2017 Jan.

Authors

Affiliations

¹ Department of Ophthalmology, Wilmer Eye Institute, Johns Hopkins University School of Medicine, Baltimore, MD, USA.
² Center for Nanomedicine, Johns Hopkins University School of Medicine, Baltimore, MD, USA ; Department of Biomedical Engineering, Johns Hopkins University School of Medicine, Baltimore, MD, USA.
³ Department of Ophthalmology, Wilmer Eye Institute, Johns Hopkins University School of Medicine, Baltimore, MD, USA ; Center for Nanomedicine, Johns Hopkins University School of Medicine, Baltimore, MD, USA.
⁴ Department of Materials Science and Engineering, Johns Hopkins University, Baltimore, MD 21218, USA ; Institute for NanoBioTechnology, Johns Hopkins University, Baltimore, MD, USA ; Translational Tissue Engineering Center, Johns Hopkins University, Baltimore, MD, USA.
⁵ Department of Ophthalmology, Wilmer Eye Institute, Johns Hopkins University School of Medicine, Baltimore, MD, USA ; Center for Nanomedicine, Johns Hopkins University School of Medicine, Baltimore, MD, USA ; Department of Chemical and Biomolecular Engineering, Johns Hopkins University, Baltimore, MD, USA.
⁶ Department of Ophthalmology, Wilmer Eye Institute, Johns Hopkins University School of Medicine, Baltimore, MD, USA ; Center for Nanomedicine, Johns Hopkins University School of Medicine, Baltimore, MD, USA ; Department of Biomedical Engineering, Johns Hopkins University School of Medicine, Baltimore, MD, USA ; Department of Chemical and Biomolecular Engineering, Johns Hopkins University, Baltimore, MD, USA ; Departments of Environmental Health Sciences, Oncology, Neurosurgery, and Pharmacology & Molecular Science, Johns Hopkins University School of Medicine, Baltimore, MD, USA.

Abstract

Purpose: To develop and evaluate an antibiotic-eluting suture for ophthalmic surgery.

Methods: Wet electrospinning was used to manufacture sutures composed of poly(L-lactide), polyethylene glycol (PEG), and levofloxacin. Size, morphology, and mechanical strength were evaluated via scanning electron microscopy and tensile strength, respectively. In vitro drug release was quantified using high performance liquid chromatography. In vitro suture activity against Staphylococcus epidermidis was investigated through bacterial inhibition studies. Biocompatibility was determined via histological analysis of tissue sections surrounding sutures implanted into Sprague-Dawley rat corneas.

Results: Sutures manufactured via wet electrospinning were 45.1 ± 7.7 μm in diameter and 0.099 ± 0.007 newtons (N) in breaking strength. The antibiotic release profile demonstrated a burst followed by sustained release for greater than 60 days. Increasing PEG in the polymer formulation, from 1% to 4% by weight, improved drug release without negatively affecting tensile strength. Sutures maintained a bacterial zone of inhibition for at least 1 week in vitro and elicited an in vivo tissue reaction comparable to a nylon suture.

Conclusions: There is a need for local, postoperative delivery of antibiotics following ophthalmic procedures. Wet electrospinning provides a suitable platform for the development of sutures that meet size requirements for ophthalmic surgery and are capable of sustained drug release; however, tensile strength must be improved prior to clinical use.

Translational relevance: No antibiotic-eluting suture exists for ophthalmic surgery. A biocompatible, high strength suture capable of sustained antibiotic release could prevent ocular infection and preclude compliance issues with topical eye drops.

Keywords: biodegradable; drug delivery; levofloxacin; medical device; ocular.