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Implantable tubes, shunts, and other medical conduits are crucial for treating a wide range of conditions from ears and eyes to brain and liver but often impose serious risks of device infection, obstruction, migration, unreliable function, and tissue damage. Efforts to alleviate these complications remain at an impasse because of fundamentally conflicting design requirements: Millimeter-scale size is required to minimize invasiveness but exacerbates occlusion and malfunction. Here, we present a rational design strategy that reconciles these trade-offs in an implantable tube that is even smaller than the current standard of care. Using tympanostomy tubes (ear tubes) as an exemplary case, we developed an iterative screening algorithm and show how unique curved lumen geometries of the liquid-infused conduit can be designed to co-optimize drug delivery, effusion drainage, water resistance, and biocontamination/ingrowth prevention in a single subcapillary–length-scale device. Through extensive in vitro studies, we demonstrate that the engineered tubes enabled selective uni- and bidirectional fluid transport; nearly eliminated adhesion and growth of common pathogenic bacteria, blood, and cells; and prevented tissue ingrowth. The engineered tubes also enabled complete eardrum healing and hearing preservation and exhibited more efficient and rapid antibiotic delivery to the middle ear in healthy chinchillas compared with current tympanostomy tubes, without resulting in ototoxicity at up to 24 weeks. The design principle and optimization algorithm presented here may enable tubes to be customized for a wide range of patient needs. 

paired with distinct reverse arcs1,2. Efforts to mimic such dynamics synthetically rely on multimaterial designs but face limits to programming arbitrary motions or diverse behaviours in one structure3–8. Here we show how diverse, complex, non-reciprocal, stroke-like trajectories emerge in a single-material system through self-regulation. When a micropost composed of photoresponsive liquid crystal elastomer with mesogens aligned oblique to the structure axis is exposed to a static light source, dynamic dances evolve as light initiates a travelling order-to-disorder transition front, transiently turning the structure into a complex evolving bimorph that twists and bends via multilevel opto-chemo-mechanical feedback. As captured by our theoretical model, the travelling front continuously reorients the molecular, geometric and illumination axes relative to each other, yielding pathways composed from series of twisting, bending, photophobic and phototropic motions. Guided by the model, here we choreograph a wide range of trajectories by tailoring parameters, including illumination angle, light intensity, molecular anisotropy, microstructure geometry, temperature and irradiation intervals and duration. We further show how this opto-chemo-mechanical self-regulation serves as a foundation for creating self-organizing deformation patterns in closely spaced microstructure arrays via light-mediated interpost communication, as well as complex motions of jointed microstructures, with broad implications for autonomous multimodal actuators in areas such as soft robotics7,9,10, biomedical devices11,12 and energy transductionmaterials13, and for fundamental understanding of self-regulated systems14,15