In Vivo Efficacy of Contact Lens Drug-Delivery Systems in Glaucoma Management. A Systematic Review

Featured Application A systematic review of in vivo studies available on the contact lens as a drug-delivery system in glaucoma therapy, also focusing on technical limitations and future perspectives. Adherence is crucial in medical glaucoma therapy, although half of the patients skip eyedrops. In recent years alternative drug-delivery systems have been developed. One of the most promising seems the contact lens (CL). This systematic review aims to present the in vivo efficacy of different CL drug-delivery systems. A total of 126 studies were identified following a literature search adhering to the preferred reporting items for systematic reviews and meta-analyses (PRISMA) guidelines. After full-text evaluation, 19 studies about CL drug-delivery systems were included. To date, the following drug-delivery systems have been investigated in vivo: drug-soaked CL, CL with physical barriers (vitamin E), molecularly imprinted CL, CL with implants, and nanoparticle-loaded CL. Nanoparticle-loaded CL and CL with implants seem the most promising drug-delivery systems, although initial burst drug release and patient acceptance may limit their widespread use in current practice. Clinical trials are warranted to understand the role of CL as a drug-delivery system in improving glaucomatous patient care.

Automated summary

This systematic review focuses on in vivo studies of contact lenses as a drug-delivery system in glaucoma therapy, highlighting technical limitations and future perspectives. Nanoparticle-loaded contact lenses and lenses with implants appear to be the most promising drug-delivery systems, although challenges such as initial burst drug release and patient acceptance may hinder their widespread use. Clinical trials are needed to further explore the role of contact lenses in improving glaucoma patient care.