Department of Ophthalmology, University of Massachusetts Medical School, Worcester, USA.
Surv Ophthalmol. 2011 Jul-Aug;56(4):300-23. doi: 10.1016/j.survophthal.2010.09.001. Epub 2011 May 24.
Vitreoretinal disorders constitute a significant portion of treatable ocular disease. Advances in vitreoretinal surgery have included the development and characterization of suitable substitutes for the vitreous. Air, balanced salt solutions, perfluorocarbons, expansile gases, and silicone oil serve integral roles in modern vitreoretinal surgery. Vitreous substitutes vary widely in their properties, serve different clinical functions, and present different shortcomings. Permanent vitreous replacement has been attempted with collagen, hyaluronic acid, hydroxypropylmethylcellulose, and natural hydrogel polymers. None, however, have proven to be clinically viable. A long-term vitreous substitute remains to be found, and recent research suggests promise in the area of synthetic polymers. Here we review the currently available vitreous substitutes, as well those in the experimental phase. We classify these compounds based on their functionality, composition, and properties. We also discuss the clinical use, advantages, and shortcomings of the various substitutes. In addition we define the ideal vitreous substitute and highlight the need for a permanent substitute with long-term viability and compatibility. Finally, we attempt to define the future role of biomaterials research and the various functions they may serve in the area of vitreous substitutes.
玻璃体积血视网膜病变构成了可治疗眼部疾病的重要部分。玻璃体视网膜手术的进步包括了为玻璃体开发和表征合适替代品。空气、平衡盐溶液、全氟化碳、膨胀气体和硅油在现代玻璃体视网膜手术中发挥着重要作用。玻璃体替代品在性质、临床功能和缺点方面差异很大。已经尝试使用胶原蛋白、透明质酸、羟丙基甲基纤维素和天然水凝胶聚合物来进行永久性玻璃体置换，但没有一种被证明在临床上是可行的。目前仍需要寻找一种长期的玻璃体替代品，最近的研究在合成聚合物领域显示出了希望。在这里，我们回顾了目前可用的玻璃体替代品，以及处于实验阶段的替代品。我们根据它们的功能、组成和性质对这些化合物进行分类。我们还讨论了各种替代品的临床应用、优点和缺点。此外，我们定义了理想的玻璃体替代品，并强调需要一种具有长期生存能力和相容性的永久性替代品。最后，我们试图定义生物材料研究的未来作用以及它们在玻璃体替代品领域可能发挥的各种功能。
