Long-term stable wireless smart contact lens for robust digital diabetes diagnosis.

Wearable devices for digital continuous glucose monitoring (CGM) have attracted great attention as a new paradigm medical device for diabetes management. However, the relatively inaccurate performance and instability of CGM devices have limited their wide applications in the clinic. Here, we developed hyaluronate (HA) modified Au@Pt bimetallic electrodes for long-term accurate and robust CGM of smart contact lens. After glucose oxidation reaction, the bimetallic electrodes facilitated the rapid decomposition of hydrogen peroxide and charge transfer for robust CGM. The passivation of Au@Pt bimetallic electrode with branch-type thiolated HA prevented the dissolution of Au electrode by chloride ions in tears. In diabetic and normal rabbits, the smart contact lens with HA-Au@Pt bimetallic electrodes enabled the high correlation (ρ = 0.88) CGM with 98.6% clinically acceptable data for 3 weeks. Taken together, we could confirm the feasibility of our smart contact lens for long-term CGM for further clinical development.

Wireless theranostic smart contact lens for monitoring and control of intraocular pressure in glaucoma.

Glaucoma is one of the irreversible ocular diseases that can cause vision loss in some serious cases. Although Triggerfish has been commercialized for monitoring intraocular pressure in glaucoma, there is no smart contact lens to monitor intraocular pressure and take appropriate drug treatment in response to the intraocular pressure levels. Here, we report a precisely integrated theranostic smart contact lens with a sensitive gold hollow nanowire based intraocular pressure sensor, a flexible drug delivery system, wireless power and communication systems and an application specific integrated circuit chip for both monitoring and control of intraocular pressure in glaucoma. The gold hollow nanowire based intraocular pressure sensor shows high ocular strain sensitivity, chemical stability and biocompatibility. Furthermore, the flexible drug delivery system can be used for on-demand delivery of timolol for intraocular pressure control. Taken together, the intraocular pressure levels can be successfully monitored and controlled by the theranostic smart contact lens in glaucoma induced rabbits. This theranostic smart contact lens would be harnessed as a futuristic personal healthcare platform for glaucoma and other ocular diseases.

Bimetallic Nanocatalysts Immobilized in Nanoporous Hydrogels for Long-Term Robust Continuous Glucose Monitoring of Smart Contact Lens.

Smart contact lenses for continuous glucose monitoring (CGM) have great potential for huge clinical impact. To date, their development has been limited by challenges in accurate detection of glucose without hysteresis for tear glucose monitoring to track the blood glucose levels. Here, long-term robust CGM in diabetic rabbits is demonstrated by using bimetallic nanocatalysts immobilized in nanoporous hydrogels in smart contact lenses. After redox reaction of glucose oxidase, the nanocatalysts facilitate rapid decomposition of hydrogen peroxide and nanoparticle-mediated charge transfer with drastically improved diffusion via rapid swelling of nanoporous hydrogels. The ocular glucose sensors result in high sensitivity, fast response time, low detection limit, low hysteresis, and rapid sensor warming-up time. In diabetic rabbits, smart contact lens can detect tear glucose levels consistent with blood glucose levels measured by a glucometer and a CGM device, reflecting rapid concentration changes without hysteresis. The CGM in a human demonstrates the feasibility of smart contact lenses for further clinical applications.

Smart Wireless Near-Infrared Light Emitting Contact Lens for the Treatment of Diabetic Retinopathy.

Diabetic retinopathy is currently treated by highly invasive repeated therapeutic injections and surgical interventions without complete vision recovery. Here, a noninvasive smart wireless far red/near-infrared (NIR) light emitting contact lens developed successfully for the repeated treatment of diabetic retinopathy with significantly improved compliance. A far red/NIR light emitting diode (LED) is connected with an application-specific integrated circuit chip, wireless power, and communication systems on a PET film, which is embedded in a silicone elastomer contact lens by thermal crosslinking. After in vitro characterization, it is confirmed that the retinal vascular hyper-permeability induced by diabetic retinopathy in rabbits is reduced to a statistically significant level by simply repeated wearing of smart far red/NIR LED contact lens for 8 weeks with 120 µW light irradiation for 15 min thrice a week. Histological analysis exhibits the safety and feasibility of LED contact lenses for treating diabetic retinopathy. This platform technology for smart LED contact lens would be harnessed for various biomedical photonic applications.

Smart Contact Lenses with a Transparent Silver Nanowire Strain Sensor for Continuous Intraocular Pressure Monitoring.

Continuous intraocular pressure (IOP) monitoring can provide a paradigm shift in the management of patients with glaucoma as a facile alternative to conventional diagnostic methods. However, the low sensitivity and functional instability of current IOP sensors have limited their clinical utility in the management of glaucoma. Here, we have developed a smart contact lens integrated with a transparent silver nanowire IOP strain sensor and wireless circuits for noninvasive, continuous IOP monitoring. After confirming the robust stability of the IOP sensor within the smart contact lens in the presence of tears and repeated eyelid blink model cycles, we were able to monitor IOP changes on polydimethylsiloxane model eyes in vitro. In vivo tests demonstrated that our fully integrated wireless smart contact lens could successfully monitor the change in IOP in living rabbit eyes, which was clearly validated by the conventional invasive tonometer IOP test. Taken together, we could confirm the feasibility of our smart contact lens as a noninvasive platform for continuous IOP monitoring of glaucoma patients.

Wireless smart contact lens for diabetic diagnosis and therapy.

A smart contact lens can be used as an excellent interface between the human body and an electronic device for wearable healthcare applications. Despite wide investigations of smart contact lenses for diagnostic applications, there has been no report on electrically controlled drug delivery in combination with real-time biometric analysis. Here, we developed smart contact lenses for both continuous glucose monitoring and treatment of diabetic retinopathy. The smart contact lens device, built on a biocompatible polymer, contains ultrathin, flexible electrical circuits and a microcontroller chip for real-time electrochemical biosensing, on-demand controlled drug delivery, wireless power management, and data communication. In diabetic rabbit models, we could measure tear glucose levels to be validated by the conventional invasive blood glucose tests and trigger drugs to be released from reservoirs for treating diabetic retinopathy. Together, we successfully demonstrated the feasibility of smart contact lenses for noninvasive and continuous diabetic diagnosis and diabetic retinopathy therapy.

Fabrication of Foldable Metal Interconnections by Hybridizing with Amorphous Carbon Ultrathin Anisotropic Conductive Film.

With the advent of foldable electronics, it is necessary to develop a technology ensuring foldability when the circuit lines are placed on the topmost substrate rather than in the neutral plane used in the present industry. Considering the potential technological impacts, conversion of the conventional printed circuit boards to foldable ones is most desirable to achieve the topmost circuitry. This study realizes this unconventional conversion concept by coating an ultrathin anisotropic conductive film (UACF) on a printed metal circuit board. This study presents rapid large-area synthesis of hydrogenated amorphous carbon (a-C:H) thin films and their use as the UACF. Since the synthesized a-C:H thin film has electrical transparency, the metal/a-C:H hybrid board reflects the complexity of the underlying metal circuit board. The a-C:H thin film electrically connects the cracked area of the metal line; thus, the hybrid circuit board is foldable without resistance change during repeated folding cycles. The metal/UACF hybrid circuit board can be applied to the fabrication of various foldable electronic devices.

Effect of ion migration in electro-generated chemiluminescence depending on the luminophore types and operating conditions.

Electro-generated chemiluminescence (ECL) has attracted increasing attention as a new platform for light-emitting devices; in particular, the use of mechanically stretchable ECL gels opens up the opportunity to achieve deformable displays. The movements of radical ions under an external electric field include short-range diffusion near the electrodes and long-distance migration between the electrodes. So far, only the diffusion of radical ions has been considered as the operating principle behind ECL. In this study, electrochemical and optical analysis was performed systematically to investigate the role of ion migration in ECL devices. This study reveals that long-distance migration of radical ions can be a key variable in ECL at low frequencies and that this effect depends on the type of ion species and the operating conditions (e.g. voltage and frequency). We also report that the emissions from the two electrodes are not identical, and the emission behaviors are different in the optimal operating conditions for the red, green, and blue ECL emissions.

Fully Elastic Conductive Films from Viscoelastic Composites.

We investigated, for the first time, the conditions where a thermoplastic conductive composite can exhibit completely reversible stretchability at high elongational strains (ε = 1.8). We studied a composite of Au nanosheets and a polystyrene-block-polybutadiene-block-polystyrene block copolymer as an example. The composite had an outstandingly low sheet resistance (0.45 Ω/sq). We found that when a thin thermoplastic composite film is placed on a relatively thicker chemically cross-linked elastomer film, it can follow the reversible elastic behavior of the bottom elastomer. Such elasticity comes from the restoration of the block copolymer microstructure. The strong adhesion of the thermoplastic polymer to the metallic fillers is advantageous in the fabrication of mechanically robust, highly conductive, stretchable electrodes. The chemical stability of the Au composite was used to fabricate high luminescence, stretchable electrochemiluminescence displays with a conventional top-bottom electrode setup and with a horizontal electrode setup.

Improved stability of transparent PEDOT:PSS/Ag nanowire hybrid electrodes by using non-ionic surfactants.

A hybrid electrode, PEDOT:PSS/Ag NW containing a non-ionic surfactant (Triton X-100), was developed to enhance the mechanical stability of the Ag NW electrode and used for flexible ECL displays. The resulting hybrid electrode exhibited an outstanding figure of merit value of 12.3 × 10-3 Ω-1 and stable luminescence efficiency under the bending test.

Stretchable E-Skin Apexcardiogram Sensor.

A new strategy to measure the apex cardiogram with electronic skin technology is presented. An electronic skin apexcardiogram sensor, which can compensate the conventional electrocardiogram for cardiac diagnosis, is demonstrated through a highly sensitive and stretchable strain sensor with gold-nanoparticle composites.

Interfacing liquid metals with stretchable metal conductors.

Highly stretchable conductors are essential components in deformable electronics. Owing to their high stretchability and conductivity, liquid metals have attracted significant attention for use as circuits and interconnections. However, their poor wettability to stretchable metal electrodes prevents the formation of stable electrical connections. This study examined two approaches for creating a stable interface between a liquid metal (EGaIn) and stretchable metal electrodes via: (i) the use of honeycomb-structured stretchable metal electrodes and (ii) the addition of a conducting polymer interlayer. The line width of the honeycomb had a significant influence on the formation of a stable interface. The liquid metal formed a stable film layer on honeycomb metal electrodes, which have line widths of less than 50 µm. Coating PEDOT: PSS with a nonionic surfactant lowered the interfacial energy of EGaIn with flat stretchable metal surfaces; hence EGaIn was coated uniformly on the stretchable metal surfaces. Strain sensors were fabricated as a demonstrative example of an application that utilizes the stable interface.

Material approaches to stretchable strain sensors.

With the recent progress made in wearable electronics, devices now require high flexibility and stretchability up to large strain levels (typically larger than 30 % strain). Wearable strain sensors or deformable strain sensors have been gaining increasing research interest because of the rapid development of electronic skins and robotics and because of their biomedical applications. Conventional brittle strain sensors made of metals and piezoresistors are not applicable for such stretchable sensors. This Review summarizes recent advances in stretchable sensors and focuses on material aspects for high stretchability and sensitivity. It begins with a brief introduction to the Wheatstone bridge circuit of conventional resistive strain sensors. Then, studies on the manipulation of materials are reviewed, including waved structural approaches for making metals and semiconductors stretchable, the use of liquid metals, and conductive filler/elastomer composites by using percolation among the fillers. For capacitive strain sensors, the constant conductivity of the electrode is a key factor in obtaining reliable sensors. Possible approaches to developing capacitive strain sensors are presented. This Review concludes with a discussion on the major challenges and perspectives related to stretchable strain sensors.