Vitreous Substitutes: The Present and the Future

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.

Conditions for obtaining polyvinyl alcohol/trisodium trimetaphosphate hydrogels as vitreous humor substitute

“…[4][5][6][7] The transparency of the media is ensured by collagen-glycosaminoglycan and water in addition to acting as a support for visual accommodation mechanism. 8 Many advances in the treatment of vitreoretinal diseases have become safer and less traumatic; vitreous removal has improved treatment results and avoids any long-term problems related to the biocompatibility of liquid tamponade. 9 Nevertheless, retinal treatment options continue to expand with the development of new drugs and substances used as vitreous substitutes.…”

Characterization and Antioxidant Activity of Hyaluronan from Vitreous Humor of Yellowfin Tuna Eye (Thunnus albacares)

“…Vitreous humor dari mata ikan yang masih segar berwarna bening transparan karena kandungan air yang besar (Donati et al 2014). Vitreous humor mata tuna yang diperoleh memiliki karakteristik bening kecokelatan yang diduga telah tercampur darah dan terjadi reaksi pencokelatan.…”

Different preferences between United States and European vitreoretinal surgeons

“…A third issue relates to the use of heavy silicone oils (fluorinated, semifluorinated, and so on) for tamponade of the inferior retinal periphery [5]. Many interesting studies have been conducted, indicating that these agents may have a role in proliferative vitreoretinopathy cases, although they also seem to shift the recurrent membranes to the superior periphery and also have major difficulties with removal and adherence to other intraocular substances.…”