Real-Time Probing of Biofouling Kinetics on Orthokeratology Lenses: QCM-D Quantification of Protein/Lipid Adsorption and Multipurpose Solution-Mediated Elution under Physiological Flow

Orthokeratology (OK) lenses for myopia correction are susceptible to biofouling by tear-derived biomolecules, escalating the risks of ocular infection and inflammation. Prevailing studies that rely on end point protein quantification fail to capture the real-time kinetics of fouling formation. Here, we fabricated a UV pressure-assisted polymer-grafted quartz crystal microbalance with dissipation monitoring (QCM-D) sensor exhibiting exceptional stability, nanoscale smoothness (RMS roughness ≈2 nm), and interfacial peel resistance. This platform enables in situ tracking of adsorption/desorption kinetics for four critical tear components: native/denatured lysozyme and oxidized/native lecithin. Key findings reveal a flow-dependent fouling behavior, wherein low flow rates increase biomolecule adsorption by 37–80% compared with higher flows. We further identify denatured lysozyme and native lecithin as resilient contaminants characterized by a stronger deposition affinity and pronounced resistance to elution. Quantitative screening of multipurpose solutions (MPSs) demonstrates that MPS #2 achieves 20–100% elution rate across biomolecules, outperforming commercial benchmarks. By leveraging dissipation–frequency (D–F) analysis, we clarify the fundamental mechanisms of biofouling formation at the molecular level. Collectively, this work establishes three critical advances: (1) a real-time biofouling diagnostic platform for OK lens interfaces, (2) molecular design principles for antifouling materials based on adhesion remodeling theory, and (3) an accelerated MPS formulation screening paradigm for ocular device safety.