Zheng Chuanzhen, Wen Dejia, Xu Kejia, Zhang Xiaomin, Ren Xinjun, Li Xiaorong
Tianjin Key Laboratory of Retinal Functions and Diseases, Tianjin International Joint Research and Development Centre of Ophthalmology and Vision Science, Eye Institute and School of Optometry, Tianjin Medical University Eye Hospital, Tianjin, China.
Tianjin Fourth Central Hospital, Department of Ophthalmology, Tianjin, China.
Front Bioeng Biotechnol. 2022 Oct 17;10:997243. doi: 10.3389/fbioe.2022.997243. eCollection 2022.
Rhegmatogenous retinal detachment (RRD) is the most common retinological emergency that can cause blindness without surgical treatment. RRD occurs when liquefied vitreous accumulates between the neurosensory retina and the retinal pigment epithelium retinal breaks, which are caused by the separation of the vitreous from the retina with aging. Currently, the main treatment option is pars plana vitrectomy, which involves surgical removal of the vitreous and laser photocoagulation around retinal breaks to generate firm chorioretinal adhesion, as well as subsequent filling of the vitreous cavity with long-lasting substitutes (expansile gas or silocone oil) to prevent the connection between the subretinal space and the vitreous cavity the breaks before the chorioretinal adhesion firm enough. However, the postoperative face-down position and the not very satisfactory first retinal reattachment rate place a heavy burden on patients. With the development of technology and materials engineering, researchers have developed biomaterials that can be used as a retinal patch to seal retinal breaks and prevent the connection of subretinal space and vitreous cavity breaks, thus replacing the long-lasting vitreous substitutes and eliminating the postoperative face-down position. Preclinical studies have demonstrated that biomaterial sealants have enough biocompatibility and efficacy in the and experiments. Some sealants have been used in clinical trials on a small scale, and the results indicate promising application prospects of the biomaterial sealants as retinal patches in the repair of RRD. Herein, we review the recent advances in biomaterials as retinal patches for the repair of RRD, focusing on the biomaterial categories, methods, and procedures for sealing retinal breaks, as well as their biocompatibility and efficacy, current limitations, and development perspectives.
孔源性视网膜脱离（RRD）是最常见的视网膜急症，若不进行手术治疗可导致失明。当液化玻璃体积聚在神经感觉视网膜和视网膜色素上皮之间时，就会发生RRD，视网膜裂孔是由玻璃体随着年龄增长与视网膜分离所致。目前，主要的治疗选择是玻璃体切除术，该手术包括手术切除玻璃体并对视网膜裂孔周围进行激光光凝以形成牢固的脉络膜视网膜粘连，以及随后用长效替代物（膨胀气体或硅油）填充玻璃体腔，以防止在脉络膜视网膜粘连足够牢固之前视网膜下间隙与玻璃体腔之间通过裂孔相连。然而，术后的俯卧位以及不太理想的首次视网膜复位率给患者带来了沉重负担。随着技术和材料工程的发展，研究人员开发出了可作为视网膜补片用于封闭视网膜裂孔并防止视网膜下间隙与玻璃体腔通过裂孔相连的生物材料，从而取代长效玻璃体替代物并消除术后俯卧位。临床前研究已证明生物材料密封剂在相关实验中具有足够的生物相容性和有效性。一些密封剂已在小规模临床试验中使用，结果表明生物材料密封剂作为视网膜补片在RRD修复中具有广阔的应用前景。在此，我们综述了用于RRD修复的作为视网膜补片的生物材料的最新进展，重点关注生物材料的类别、封闭视网膜裂孔的方法和步骤，以及它们的生物相容性和有效性、当前的局限性和发展前景。
