Antibiotics-free nanomaterials against bacterial keratitis: Eliminating infections with reactive oxygen species (ROS)

Bacterial keratitis (BK), which accounts for over 50% of the reported cases of microbial keratitis, is a condition that can result in vision loss and blindness if left untreated. Antibiotics are widely adopted as the first-line treatment of BK. However, excessive use of antibiotics has resulted in antimicrobial resistance (AMR) and other adverse effects such as corneal opacification. Antibiotics-free approaches are recently explored to avoid further progression of AMR for the treatment of BK. Due to their non-invasiveness, high spatiotemporal accuracy, effective and rapid antibacterial ability, ROS-related antibacterial strategies are attracting growing attention as an antibiotics-free approach for treatment of BK. This review article provides an overview of the design and implementation of ROS-related strategies for the treatment of BK, with a focus on various types of materials including i) metal nanocomposites, ii) semiconductors, iii) carbon-based materials, and iv) photosensitive polymers. The performance of these strategies is evaluated by comparing their antibacterial efficiency, cytotoxicity, and treatment efficacy. Meanwhile, the prospects of ROS-related treatment for BK are discussed considering recent developments in the field.