Alex Hui

Corneal blindness remains a major global cause of vision loss, and the limited availability of donor tissue has intensified efforts to engineer functional corneal substitutes with appropriate optical, mechanical, and biological performance. Advances in additive manufacturing have positioned 3D printing and 3D bioprinting as promising platforms for fabricating anatomically informed constructs that may recapitulate key aspects of the cornea's hierarchical architecture. This review provides a mechanistic comparison of these technologies with respect to material systems and (bio)ink formulation, processing strategies, scaffold architecture, cell incorporation, and biological integration. Particular emphasis is placed on the trade-off between high-fidelity 3D-printed scaffolds that can be seeded after fabrication and cell-laden bioprinted constructs that better capture early cell-matrix interactions but remain constrained by bioink rheology, resolution, mechanical integrity, and shape retention.The review further examines emerging strategies, including decellularized extracellular matrix bioinks, functionally graded hydrogels, and hybrid electrospun-printed constructs, for improving bioactivity, structural mimicry, collagen alignment, optical transmittance, and stromal-like extracellular matrix deposition. Persistent challenges include nanoscale and membrane-like architectural replication, longterm phenotype stability, reproducible manufacturing, surgical handling, storage, and regulatory classification of combination products. By integrating material science, fabrication physics, cellular responses, and translational considerations, this review delineates the complementary roles of 3D printing and 3D bioprinting and identifies the key design criteria required to advance printed corneal constructs toward clinically translatable regeneration.

Purpose: Myopia is a global vision problem linked to a significant economic burden and potential blindness in severe cases. Current interventions—including atropine eye drops, contact lenses, spectacles, and lifestyle changes—are often combined due to limited individual effectiveness. This study aimed to develop and stabilize atropine formulations, load them into contact lenses, and evaluate atropine release profiles. Methods: Atropine sulfate was converted to atropine base and complexed with 2‐hydroxypropyl beta‐cyclodextrin (HPBCD) in phosphate‐buffered saline (PBS) at pH 6.5 or 7.4. Formulation stability was monitored over one year at room temperature (21°C) using high‐performance liquid chromatography (HPLC). Etafilcon A and omafilcon A lenses were soaked in the formulations for 24 hours. The amount of atropine base loaded and released was quantified via HPLC, and toxicity was assessed according to ISO 10993‐5. Results: After 1 year, the formulations retained 97.3% (pH 6.5) and 80.3% (pH 7.4) of atropine base. At pH 6.5, etafilcon A and omafilcon A absorbed 3.2 ± 0.1 μg and 1.7 ± 0.6 μg of atropine base, respectively. Etafilcon A released 100% of the atropine base within 4 hours, and omafilcon A released 59% within 2 hours. Contact lens eluates showed no toxicity. Conclusions: These findings support the stability and safety of atropine base formulations for potential ocular drug delivery.

Purpose: The purpose of this study was to investigate the quantity of radioactive lysozyme deposited on various rigid corneal lenses, and the impact of using a care solution containing a surfactant. Methods: Seven rigid corneal lens materials were investigated in this study. Lenses were soaked in an artificial tear solution (ATS), containing, among other components, radioactively labelled ¹²⁵ I‐lysozyme, for 18 h at 37°C, followed by a soak for 6 h in saline. Alternatively, a one‐step peroxide‐based disinfection solution, which contains a poloxamer as a surfactant, was used in place of saline to determine the impact of use of a care solution on deposition. This process of soaking in the ATS followed by soaking in saline or the care solution was repeated for 30 cycles to simulate one month of lens wear. The amount of radioactive lysozyme remaining on the different lenses after 30 cycles was then quantified through gamma radiation counts. Results: Use of radioactively labelled ¹²⁵ I‐lysozyme allowed for quantification of protein down to 0.19 μg/lens. Five of the seven contact lens materials tested showed a significant reduction in the amount of radioactive lysozyme remaining after using the care solution (range 1.33 ± 0.11–2.47 ± 0.13 μg/lens) compared to if only saline was used (range 1.25 ± 0.18–3.21 ± 0.66 μg/lens) after 30 simulated cycles. Conclusions: The small amounts of lysozyme deposited on rigid contact lenses can be quantified using radioactively labelled ¹²⁵ I‐lysozyme. Use of a care solution leads to lower amounts of lysozyme remaining on the lenses compared to saline, however, some lysozyme still remains and is not removed.

In response to the growing incidence of digital eye strain, a variety of spectacle and contact lens interventions have been introduced and are frequently prescribed in clinical and retail settings. However, the evidence supporting their effectiveness remains limited and inconclusive. This narrative review explores the real-world implementation of lens-based interventions for digital eye strain, focusing on how contextual factors influence prescribing practices. Using the Consolidated Framework for Implementation Research, the review examines the characteristics of these interventions, the outer setting in which they are prescribed, individuals involved in their adoption, and the processes that support or hinder their integration into routine care. Findings reveal that prescribing is often driven more by societal demand, commercial pressures, and clinician perceptions than by robust clinical evidence. Blue light filtering and anti-reflective coated spectacle lenses are commonly recommended, while contact lens interventions are less frequently studied but increasingly marketed. The review highlights a disconnect between evidence and practice and underscores the need for more rigorous research and context-specific clinical guidance to support evidence-based prescribing for digital eye strain.

SIGNIFICANCE: Contact lens wettability is potentially correlated with friction, which is linked to lens comfort. However, measuring wettability can be highly variable. This study assessed wettability using three techniques for a more accurate profile. PURPOSE: To evaluate the wettability of contemporary daily disposable contact lenses after 16 hours on an in vitro model using the sessile drop, captive bubble, and a novel in vit ro noninvasive keratograph breakup time (NIKBUT) method. METHODS: The wettability of six contemporary silicone hydrogel contact lens materials (verofilcon A, delefilcon A, senofilcon A, kalifilcon A, stenfilcon A, and somofilcon A) and two conventional hydrogel materials (nesofilcon A and etafilcon A) were evaluated using an in vitro blink model at t = 0 and 16 hours. The blink rates of the eye model were 20 blinks per minute. Sessile drop and captive bubble angles were analyzed using the Optical Contact Analyzer. NIKBUT was assessed on a blink model in combination with the OCULUS Keratograph 5M. RESULTS: There were no significant differences in wettability for any lens types between 0 and 16 hours when assessed using the captive bubble or NIKBUT methods (p>0.05). For the sessile drop method, verofilcon A had the lowest contact angle values (36.5 ± 2.9°), and all lenses except for etafilcon A had similar wettability after 16 hours. All the lenses had similar wettability when assessed using the captive bubble method, suggesting that they had similar wettability under optimal wetting conditions. For NIKBUT, delefilcon A had the longest NIKBUT values (9.0 ± 1.0 s) after 16 hours. CONCLUSIONS: The sessile drop technique produced the most measurable differences in wettability between different lens types, whereas the captive bubble technique was not able to provide any measurable differences between lenses. NIKBUT measurements may provide a better measure of on‐eye wettability, but variability in the results using the current eye model still needs to be addressed in future studies for improved repeatability. Although the contact lenses showed different contact angles and NIKBUT results, their in vitro wettability did not significantly change over the 16 hours of simulated wear in terms of the captive bubble or NIKBUT values.

With rising multidrug-resistant yeast pathogens, conventional antifungals are becoming less effective, urging the need for adjuvants that enhance their activity at lower doses. This study evaluated the synergistic activity of antimicrobial peptidomimetics (TM8 and RK758) or colistin sulphate in combination with conventional antifungals against Candida albicans, C. tropicalis, C. parapsilosis, Meyerozyma guilliermondii, Nakaseomyces glabratus, Pichia kudriavzevii and Kluyveromyces marxianus, and Candidozyma auris using the checkerboard microdilution test. RK758 was synergistic with fluconazole in 78% of isolates, with the remaining 22% of isolates still showing partial synergy; it showed synergy with amphotericin B in 56% of isolates, and with caspofungin, 78% of isolates exhibited either synergy or partial synergy. TM8 showed synergy with fluconazole in 44% (with partial synergy in another 44%) of isolates, with amphotericin B in 67% of isolates, and with caspofungin in 44% (with partial synergy in another 44%) of isolates. Colistin with fluconazole or caspofungin exhibited synergy or partial synergy in 56% of the isolates. No antagonism was observed in any of the combinations. Additionally, a time-kill assay further demonstrated synergistic activity between fluconazole and TM8 or RK758. The effects of these peptidomimetics on cell membrane integrity were demonstrated in an ergosterol binding assay, supported by SYTOX Green and cellular leakage assays, both indicating a lytic effect. These results suggest that peptidomimetics can synergise with conventional antifungals, offering a potential strategy for combination therapy against yeast infections. The membrane lytic activity of the peptidomimetics likely plays a role in their synergistic interaction with antifungals, thereby enhancing the antimicrobial activities of both compounds at sub-MIC levels.

Eye drops, the most common method for anterior segment treatment, face challenges of inefficiency, with less than 7% instilled drugs typically reaching target tissues of interest. The advent of contact lens drug delivery systems offers a paradigm shift, enhancing drug residence time and bioavailability on the ocular surface. This review focuses on the considerations and challenges in developing contact lenses for drug delivery, particularly for managing four categories of ocular diseases: anterior segment infections, dry eye disease, ocular allergies, and glaucoma. Each disease category requires tailored therapeutic approaches, and the technical intricacies of drug-releasing contact lenses must address concerns related to lens properties, drug release duration, and safety. The aim of this review is to provide insights into the therapeutic needs of ocular diseases and offer a comprehensive overview of the progress made in this innovative approach. The emergence of a commercially available ketotifen fumarate-releasing lens serves as a testament to the feasibility and potential benefits of this innovative approach, paving the way for further refinement and targeted applications in ocular therapeutics.

Introduction Myopia is the most common refractive error worldwide, but each dioptre increase in myopia leads to an increased risk of degenerative eye disease and permanent vision impairment. Soft contact lens (CL) designs have been developed to slow myopia and potentially reduce long-term risk, but there is still a need for additional designs of varied materials and parameters to cater for diverse patient needs. The MultifocAL COntact Lenses for Myopia control study aims to compare the efficacy of the Acuvue Oasys for Presbyopia (AOP) CL against the Food and Drug Administration approved MiSight 1-Day multifocal CL in controlling progressive myopia in children using a non-inferiority contralateral eye design. Methods and analysis A double-blind, contralateral eye, non-inferiority, randomised, controlled clinical trial will be conducted at University of New South Wales Sydney, Australia (UNSW). Children (6 to 12 years of age, inclusive) will be randomised to wear AOP in their right or left eye, with the MiSight 1-Day CL fitted to the contralateral eye. The primary outcome is the difference in axial length and cycloplegic objective refraction change between the two CLs over 12 months. Additional outcomes include quality of life, pupillometry and adherence to treatment. To achieve a statistical power of 80% to demonstrate non-inferiority of the AOP to the MiSight 1-Day and taking into consideration a 20% discontinuation rate, the calculated sample size is 72. This trial started recruitment during the recent COVID-19 pandemic in January 2021. Ethics and dissemination Ethics approval has been obtained from the UNSW Human Research Ethics Committee (HC200052), and the study complies with the Declaration of Helsinki and the International Council for Harmonisation of Technical Requirements for Pharmaceuticals for Human Use Good Clinical Practice guidelines. The results of this trial will be disseminated in peer-reviewed publications and conference presentations. Trial registration number ACTRN12620000159954, CTN-00 282–1 v2, NCT06887920.