Molecular aggregation–driven behaviour of amphotericin B in drug-eluting contact lenses : PBP-WM_363

Infectious keratitis can progress rapidly, with corneal perforation occurring in under 48 hours. Although bacterial infections account for most cases, fungal and amoebic keratitis are more difficult to manage due to their slow onset and poor response to conventional therapy. Current topical treatments are limited by rapid drug clearance from the ocular surface, resulting in subtherapeutic concentrations. Amphotericin B (AmB) is a key antifungal agent, yet its low aqueous solubility restricts its ophthalmic use. This study explores the potential of commercially available contact lenses as carriers for sustained AmB delivery. We evaluated the loading capacity and release behaviour of AmB in its monomeric and dimeric (oligomeric) states across three lens materials with different compositions. Dimeric AmB demonstrated markedly higher loading in nelfilcon A, omafilcon A, and delefilcon A lenses, with omafilcon A achieving up to 100 µg per lens. Release studies in aqueous media showed a sustained release over three hours, offering a potential advantage over conventional eye drops by prolonging drug exposure on the corneal surface. These findings suggest that contact lenses may represent a promising platform for enhancing AmB ocular delivery and improving therapeutic outcomes in fungal keratitis.