Commercial orthokeratology lens engineered with multifunctional coatings for intelligently treating bacterial infection and biofouling

Myopia has become a primary cause of irreversible blindness and visual impairment, with its prevalence continuing to rise globally. Orthokeratology (OK) lenses are highly effective in managing myopia progression; however, they are prone to promoting tear protein adhesion and bacterial infections during use, which compromises their safety and efficacy. This study aimed to establish a novel surface modification technique to enhance the antifouling and antibacterial properties of OK lenses through the commodification of aminophenylboronic acid (NBA)-incorporated poly(methacrylic acid) (PMAA) and poly-l-lysine (PLL) brushes mediated by a polydopamine (PDA) coating. Taking advantage of the pH-responsive property of the PMAA brushes, the designed coating could intelligently switch biofunctions from antifouling to antibacterial on demand. PMAA brushes can form a dense hydration layer on a material surface, effectively resist protein adhesion, and demonstrate good biocompatibility under physiological conditions. Upon encountering bacterial adhesion, the outstretched brushes would collapse, exposing the PLL, which would immediately kill the contacted bacteria. When numerous bacteria adhere to the surface, the acidic environment leads to the breakage of Schiff base bonds,. resulting in the release of PLL and the responsive killing of bacteria. Resulting in the release of PLL and the responsive killing of bacteria. The near-infrared (NIR) light-responsive layer of PDA can effectively enhance the bactericidal effects of the coating under NIR irradiation. The OK-PDA-PMAA-PLL-NBA lens is excellent for bacterial sterilization and resists protein adhesion, demonstrating excellent biocompatibility and leading to fewer complications, thus providing an innovative and promising approach for combating myopia.