Effect of Artificial Tear Formulations on the Metabolic Activity of Human Corneal Epithelial Cells after Exposure to Desiccation.

Artificial lipid-containing tear formulations are developed to reduce tear evaporation by the restoration of a deficient tear lipid layer. Artificial tear formulations that prevent cell desiccation will result in ocular surface protection and the maintenance of cell metabolic activity. During dehydration, cells undergo the process of loss of metabolic activity and subsequently cell death. This work describes a method for assessing the efficacy of artificial tear formulations. The metabolic dye (i.e., alamarBlue) changes from a low fluorescent molecule resazurin to a fluorescent molecule resorufin in viable cells. The biological performance of an artificial tear formulation is measured as the ability of the formulation to (a) maintain cell viability and (b) provide cell protection from desiccation. Growth media and saline are used as controls for the cell viability/desiccation tests. Cells are incubated with test solutions for 30 min and then desiccated for 0 or 5 min at 37 °C and 45% relative humidity. Cell metabolic activity after initial exposure and after cell desiccation is then determined. The results show the comparative effects of eye drop formulations on cell metabolic activity and desiccation protection. This method can be used to test dry eye formulations that are designed to treat individuals with evaporative dry eye.

Effects of a Hyaluronic Acid/Hydroxypropyl Guar Artificial Tear Solution on Protection, Recovery, and Lubricity in Models of Corneal Epithelium.

PURPOSE: Hydroxypropyl guar (HPG) and hyaluronic acid (HA) have been individually shown to improve dry eye symptoms. The purpose of this in vitro study was to assess the potential benefits of a new lubricant eye drop formulation containing the demulcents propylene glycol and polyethylene glycol and an HA/HPG dual polymer in models of the human corneal epithelium. METHODS: Cultured human corneal epithelial or corneal-limbal epithelial cells were treated with the HA/HPG dual-polymer formulation or single-polymer formulations containing either HPG or HA. Desiccation protection by cell hydration and surface retention was assessed using cell viability assays. Sodium fluorescein permeability, transepithelial resistance, and cell viability assays were conducted using pretreated cells exposed to a surfactant/detergent insult to evaluate cell and cell barrier protection. Surface lubricity was assessed in tribological experiments of pericardium-pericardium friction. RESULTS: Hydration protection against desiccation and protection by surface retention were significantly greater with the HA/HPG formulation versus HPG or HA (P<0.001) alone and with HPG versus HA (P ≤ 0.016). Fluorescein permeability and transepithelial resistance assays demonstrated significantly better cell and barrier protection from surfactant insult with HA/HPG versus the single-polymer formulations (P ≤ 0.01). After insult, there were markedly more viable cells evident with HA/HPG compared with HPG or HA alone. HA/HPG and HPG reduced surface friction to a greater extent than HA (P ≤ 0.02) and maintained lubricity after the formulations were rinsed away. CONCLUSIONS: HA/HPG provided effective hydration and lubrication and demonstrated prolonged retention of effect. HA/HPG may potentially promote desiccation protection and retention on the ocular surface.

Interfacial dilatational viscoelasticity of human meibomian lipid films.

PURPOSE/AIM: The meibomian lipid layer is able to withstand the enormous stresses and deformations that occur during blinking due to the combination of its elastic and viscous properties. The purpose of this study was to measure the dilatational viscoelasticity of in vitro meibomian lipid films and compare how these properties differ between room temperature and physiological temperatures. Viscoelasticity was also compared with meibomian lipid films seeded with cholesterol or ß-carotene (the levels of these lipid species change in disease states). MATERIALS AND METHODS: Dilatational viscoelasticity (E) was measured using an oscillating pendant drop method. Measurements were carried out on spread films at the air-water interface as a function of frequency (0.1256-12.56 rad/s) at various temperatures between 18-43 °C. RESULTS: Generally, E gradually decreased as the overall temperature was increased. At both 37 and 20 °C, films demonstrated that the elastic modulus (E') was more dominant than the viscous modulus (E″), indicating films were more solid-like than fluid-like, regardless of temperature. E' and E″ were also dependant on frequency, indicating some molecular rearrangements of the lipid molecules as films were compressed and expanded. Films seeded with cholesterol or ß-carotene showed a modest increase in the moduli. CONCLUSIONS: These results are consistent with previous findings which have predicted and indicated that the meibomian lipid layer is a viscoelastic film at the air-liquid interface. These properties are integral to how the tear film lipid layer is able to maintain its structure, and hence integrity of the ocular surface.

Molecular structure of interfacial human meibum films.

Meibum is the primary component of the tear film lipid layer. Thought to play a role in tear film stabilization, understanding the physical properties of meibum and how they change with disease will be valuable in identifying dry eye treatment targets. Grazing incidence X-ray diffraction and X-ray reflectivity were applied to meibum films at an air-water interface to identify molecular organization. At room temperature, interfacial meibum films formed two coexisting scattering phases with rectangular lattices and next-nearest neighbor tilts, similar to the Ov phase previously identified in fatty acids. The intensity of the diffraction peaks increased with compression, although the lattice spacing and molecular tilt angle remained constant. Reflectivity measurements at surface pressures of 18 mN/m and above revealed multilayers with d-spacings of 50 Å, suggesting that vertical organization rather than lateral was predominantly affected by meibum-film compression.

Temperature-induced transitions in the structure and interfacial rheology of human meibum.

Meibomian lipids are the primary component of the lipid layer of the tear film. Composed primarily of a mixture of lipids, meibum exhibits a range of melt temperatures. Compositional changes that occur with disease may alter the temperature at which meibum melts. Here we explore how the mechanical properties and structure of meibum from healthy subjects depend on temperature. Interfacial films of meibum were highly viscoelastic at 17°C, but as the films were heated to 30°C the surface moduli decreased by more than two orders of magnitude. Brewster angle microscopy revealed the presence of micron-scale inhomogeneities in meibum films at higher temperatures. Crystalline structure was probed by small angle x-ray scattering of bulk meibum, which showed evidence of a majority crystalline structure in all samples with lamellar spacing of 49 Å that melted at 34°C. A minority structure was observed in some samples with d-spacing at 110 Å that persisted up to 40°C. The melting of crystalline phases accompanied by a reduction in interfacial viscosity and elasticity has implications in meibum behavior in the tear film. If the melt temperature of meibum was altered significantly from disease-induced compositional changes, the resultant change in viscosity could alter secretion of lipids from meibomian glands, or tear-film stabilization properties of the lipid layer.

Insertion mechanism of a poly(ethylene oxide)-poly(butylene oxide) block copolymer into a DPPC monolayer.

Interactions between amphiphilic block copolymers and lipids are of medical interest for applications such as drug delivery and the restoration of damaged cell membranes. A series of monodisperse poly(ethylene oxide)-poly(butylene oxide) (EOBO) block copolymers were obtained with two ratios of hydrophilic/hydrophobic block lengths. We have explored the surface activity of EOBO at a clean interface and under 1,2-dipalmitoyl-sn-glycero-3-phosphocholine (DPPC) monolayers as a simple cell membrane model. At the same subphase concentration, EOBO achieved higher equilibrium surface pressures under DPPC compared to a bare interface, and the surface activity was improved with longer poly(butylene oxide) blocks. Further investigation of the DPPC/EOBO monolayers showed that combined films exhibited similar surface rheology compared to pure DPPC at the same surface pressures. DPPC/EOBO phase separation was observed in fluorescently doped monolayers, and within the liquid-expanded liquid-condensed coexistence region for DPPC, EOBO did not drastically alter the liquid-condensed domain shapes. Grazing incidence X-ray diffraction (GIXD) and X-ray reflectivity (XRR) quantitatively confirmed that the lattice spacings and tilt of DPPC in lipid-rich regions of the monolayer were nearly equivalent to those of a pure DPPC monolayer at the same surface pressures.

The interfacial viscoelastic properties and structures of human and animal Meibomian lipids.

As the interface between the aqueous layer of the tear film and air, the lipid layer plays a large role in maintaining tear film stability. Meibomian lipids are the primary component of the lipid layer; therefore the physical properties of these materials may be particularly crucial to the functionality of the tear film. Surface pressure versus area isotherms, interfacial shear and extensional rheology, and Brewster angle microscopy (BAM) were used to characterize the Meibomian lipids from different species known to have different lipid compositions. The isotherms of humans, bovinae, wallabies, rabbits and kultarrs (a small desert marsupial) were qualitatively similar with little hysteresis between compression and expansion cycles. In contrast, several isocycles were necessary to achieve equilibrium behavior in the koala lipids. With the exception of kultarr lipids, the interfacial complex viscosity of all samples increased by one or two orders of magnitude between surface pressures of 5 mN/m and 20 mN/m and exhibited classic gel behavior at higher surface pressures. In contrast, the kultarr lipids were very fluid up to 22 mN/m; the behavior did not depend on surface pressure. Human lipids were very deformable in extensional flow and the BAM images revealed that the film became more homogeneous with compression as the elasticity of the film increased. The morphology of the kultarr lipids did not change with compression indicating a strong correlation between film structure and behavior. These results suggest that the lipid layer of the tear film forms a gel in vivo, which may aid in mechanically stabilization of the tear film.

Effect of lysozyme adsorption on the interfacial rheology of DPPC and cholesteryl myristate films.

A model tear film lipid layer composed of a binary mixture of cholesteryl myristate (CM) and 1,2-dipalmitoyl- sn-glycero-3-phosphocholine (DPPC) was characterized using surface tension measurements, Brewster angle microscopy (BAM) and interfacial stress rheology (ISR). Isotherms showed that films containing >or=90 mol % CM have a 17-fold greater % area loss between the first and second compressions than the films with less CM. BAM images clearly showed that CM films did not expand after compression, and solid-like regions extending 1-2 mm were observed at low pressures (1 mN/m). Lipid films with or=50 mol % CM became elastic at higher surface pressures. Increasing CM content reduced the surface pressure at which the mixed film became elastic. Lysozyme adsorption into a CM film increased the compressibility and resulted in a more expanded film. Lysozyme increased the ductility of the CM/DPPC films with no film breakdown occurring up to the highest pressure measured (40 mN/m). In summary, CM increased the elasticity of the lipid films, but also caused them to become brittle and incapable of expansion following compression. Lysozyme adsorption increased the ductility and decreased the isotherm hysteresis for CM/DPPC films.

Precorneal residence time of artificial tears measured in dry eye subjects.

PURPOSE: The purpose of this investigation was to measure the precorneal residence time of saline and five marketed artificial tears in dry eye subjects using fluorometry. METHODS: FITC-dextran, 70 kDa molecular weight, was admixed under sterile conditions (0.1% wt/vol) into buffered saline and the marketed artificial tear formulations of varying viscosity. Precorneal residence time (RT) was measured directly in 16 mild to moderate dry eye subjects, classified by sub-type, in a six-way cross-over, masked and randomized study. FITC-dextran tracer decay with a scanning fluorometer was used to estimate the gross RT (i.e., the time in minutes for the signal to return to baseline). RESULTS: All subjects were classified as having non-inflammatory meibomian gland dysfunction except one, who had a mixture of aqueous deficiency and meibomian gland dysfunction. In two separate determinations, the saline RTs were 19.1 +/- 7.4 and 17.6 +/- 8.2 min. The RTs for the formulations varied to some degree by viscosity, with two higher viscosity formulations demonstrating the longest RTs of 36 to 41 min, approximately twice that of saline (p < 0.001 for both 0.4% polyethylene glycol/0.3% propylene glycol, and 1.0% carboxymethylcellulose). An oil emulsion, low viscosity carboxymethylcellulose and moderate viscosity hydroxypropylmethylcellulose-containing formulation were not statistically different from saline (RTs of 18, 22 and 24 min, p values = 0.983, 0.818 and 0.099, respectively). CONCLUSIONS: More than two-fold RT differences were found for the higher viscosity, more muco-adhesive formulations compared to saline. However, other formulations provided RTs close to saline, suggesting that RT is influenced by factors other than simple viscosity. Future studies should examine the interplay of spreading characteristics, pseudoplasticity and muco-adhesion relative to RT to determine the individual and cumulative effects on formulation retention.

Dynamic wettability properties of a soft contact lens hydrogel.

The wettability of poly[2-hydroxyethyl methacrylate-co-methacrylic acid] (pHEMA-MAA) soft contact lenses was investigated in the absence and presence of block copolymer surfactants and lysozyme using the sessile drop method. The advancing dynamic contact angles (Thetaw/a) values are reported for water as a function of sequential wetting and drying cycles. The Thetaw/a values for the pHEMA-MAA in the absence of surfactant and lysozyme increased from approximately 20 degrees to 100 degrees as the number of cycles increased from two to ten, and they were independent of the pHEMA-MAA bulk water content. The change from the highly hydrophilic to hydrophobic pHEMA-MAA surface could not be reversed using the sequential wetting and drying cycles even under repeated exposures to saline solution. The effect of block copolymer surfactants with different molecular weights (MW) and hydrophilic-lipophilic balance (HLB) values on the pHEMA-MAA wettability were also studied. Low Theta(w/a) values were observed for pHEMA-MAA hydrogels that were treated with T1304 (MW 10500, HLB 14) and T904 (MW 6700, HLB 15). The surface tension data indicated that these surfactants were incompletely desorbed from the pHEMA-MAA and that the rate of desorption was slow in the timescale of the cycling experiments. Comparatively, poor wettability was observed for pHEMA-MAA surfaces presoaked in T304 (MW 1650, HLB 16) and T1107 (MW 15000, HLB 24) as Thetaw/a values greater than 90 degrees were measured for these surfactants. The surface tension data indicated that the rate of desorption of T304 and T1107 from the pHEMA-MAA was rapid and that they had a low affinity to the pHEMA-MAA. High contact angles were observed for the pHEMA-MAA hydrogels treated with lysozyme and also for the T1107 presoaked pHEMA-MAA that was also treated with lysozyme. Zero wetting angles throughout the sequential cycling were observed for the T1304 pre-treated pHEMA-MAA that had been treated with lysozyme. These results suggested that the adsorbed lysozyme on the pHEMA-MAA hydrogel had no significant influence on its wetting properties when the hydrogel was pre-treated with T1304.