Biomaterials are implanted in millions of individuals worldwide each year. Both naturally derived and synthetic
biomaterials induce a
foreign body reaction that often culminates in fibrotic encapsulation and reduced functional lifespan. In ophthalmology,
glaucoma drainage implants (
GDIs) are implanted in the eye to reduce intraocular pressure (IOP) in order to prevent
glaucoma progression and vision loss. Despite recent efforts towards miniaturization and surface chemistry modification, clinically available
GDIs are susceptible to high rates of
fibrosis and surgical failure. Here, we describe the development of synthetic, nanofiber-based
GDIs with partially degradable inner cores. We evaluated
GDIs with nanofiber or smooth surfaces to investigate the effect of surface topography on implant performance. We observed in vitro that nanofiber surfaces supported fibroblast integration and quiescence, even in the presence of pro-fibrotic signals, compared to smooth surfaces. In rabbit eyes,
GDIs with a nanofiber architecture were biocompatible, prevented hypotony, and provided a volumetric aqueous outflow comparable to commercially available
GDIs, though with significantly reduced fibrotic encapsulation and expression of key fibrotic markers in the surrounding tissue. We propose that the physical cues provided by the surface of the nanofiber-based
GDIs mimic healthy extracellular matrix structure, mitigating fibroblast activation and potentially extending functional GDI lifespan.