| Summary: | Obstruction of the lacrimal drainage system can lead to constant tearing (watery eyes, “epiphora”) resulting in irritation of the eye region, disturbed vision and therefore serious reduction of life comfort. Watery eyes are a frequently encountered symptom in daily ophthalmological practice more seen in the elderly patient, but also in young people and children. Current treatment options of epiphora due to lacrimal duct obstructions in the upper part of the drainage system are very limited. In 1963 Lester Jones developed a bypass system formed by a rigid glass tube guiding the tear straight into the nasal cavity. This tube causes frequent complications due to dislocation, blockage and irritation of the eye and nose. Other options include reopening of the drainage system with drills or lasers and placement of stents. None of these options are optimal. The aim of this research was the development of a new lacrimal duct device using a novel nanocomposite polymer based on polyhedral oligomeric silsesquioxanes (POSS) nanoparticles and poly (carbonate-urea)urethane (PCU). POSS self assembles on surface during extrusion and creates a nanotopography surface. The small diameter conduit was manufactured for replacement of a non-functional or missing upper lacrimal duct (canaliculus). Several methodologies including ultrasound atomisation, electrodynamic spraying, dip coating and coagulation techniques were used to construct a lacrimal drainage conduit (LDC) using POSS-PCU, with a diameter of 800 μm representing the size of a canaliculus. In a further development of the research we manufactured a POSS-PCU nanocomposite modified with silver nanoparticles (nanosilver) enhancing the antimicrobial and antiscarring properties of the conduit. Extensive material testing was performed to optimise the synthetic LDC. Finally, the LDC made of POSS-PCU with nanosilver was implanted for the first time in human, in a 41-year old patient in a compassionate case with successful outcome.
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