Abstract
Vitreoretinal surgery has advanced in numerous directions during recent years. The removal of the vitreous body is one of the main characteristics of this surgical procedure. Several molecules have been tested in the past to fill the vitreous cavity and to mimic its functions. We here review the currently available vitreous substitutes, focusing on their molecular properties and functions, together with their adverse effects. Afterwards we describe the characteristics of the ideal vitreous substitute. The challenges facing every ophthalmology researcher are to reach a long-term intraocular permanence of vitreous substitute with total inertness of the molecule injected and the control of inflammatory reactions. We report new polymers with gelification characteristics and smart hydrogels representing the future of vitreoretinal surgery. Finally, we describe the current studies on vitreous regeneration and cell cultures to create new intraocular gels with optimal biocompatibility and rheological properties.
Highlights
In recent times vitreoretinal surgery has made important progress regarding instruments, drugs, and materials [1, 2]
Afterwards we describe the characteristics of the ideal vitreous substitute
We report new polymers with gelification characteristics and smart hydrogels representing the future of vitreoretinal surgery
Summary
In recent times vitreoretinal surgery has made important progress regarding instruments, drugs, and materials [1, 2]. Numerous pathologies, such as retinal detachment, diabetic retinopathy, and proliferative vitreoretinopathy, require partial or total vitreous removal [3]. Temporary and permanent intraocular vitreal substitutes mainly have a structural function to ensure retinal adherence following cryo or laser retinopexy for the necessary time, to control intraocular hemorrhages, and to maintain intraocular pressure. One of the main challenges is the control of inflammatory and immune-system reactions that modify the stability of the vitreous substitute and the integrity and functionality of intraocular structures [5]. We examine the characteristics of the vitreous, the advantages and disadvantages of presently available tamponades, the characteristics of several vitreal substitutes studied some years ago but not used for several reasons, and new substances for vitreous substitution that are under research
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