Department of Ophthalmology, The Second Hospital of Jilin University, Changchun 130041, China.
Department of Ophthalmology, The Second Hospital of Jilin University, Changchun 130041, China.
Biomed Pharmacother. 2024 Mar;172:116154. doi: 10.1016/j.biopha.2024.116154. Epub 2024 Feb 1.
Vitreous replacement is a commonly employed method for treating a range of ocular diseases, including posterior vitreous detachment, complex retinal detachment, diabetic retinopathy, macular hole, and ocular trauma. Various clinical substitutes for vitreous include air, expandable gas, silicone oil, heavy silicone oil, and balanced salt solution. However, these substitutes have drawbacks such as short retention time, cytotoxicity, high intraocular pressure, and the formation of cataracts, rendering them unsuitable for long-term treatment. Polymeric hydrogels possess the potential to serve as ideal vitreous substitutes due to their structure-mimicking to natural vitreous and adjustable mechanical properties. Replacement with hydrogels as the tamponade can help maintain the shape of the eyeball, apply pressure to the detached retina, and ensure the metabolic transport of substances without impairing vision. This literature review examines the required properties of artificial vitreous, including the optical properties, rheological properties, expansive force action, and physiological and biochemical functions of chemically and physically crosslinked hydrogels. The strategies for enhancing the biocompatibility and injectability of hydrogels are also summarized and discussed. From a clinical ophthalmology perspective, this paper presents the latest developments in vitreous replacement, providing clinicians with a comprehensive understanding of hydrogel clinical applications, which offers guidance for future design directions and methodologies for hydrogel development.
玻璃体替代是治疗多种眼部疾病的常用方法,包括后玻璃体脱离、复杂视网膜脱离、糖尿病性视网膜病变、黄斑裂孔和眼外伤。各种临床玻璃体替代品包括空气、可膨胀气体、硅油、重硅油和平衡盐溶液。然而,这些替代品存在保留时间短、细胞毒性、眼内压高和白内障形成等缺点,不适合长期治疗。聚合物水凝胶由于其结构模拟天然玻璃体和可调的机械性能,有可能成为理想的玻璃体替代品。用水凝胶作为填塞物替代可以帮助保持眼球形状,对脱离的视网膜施加压力,并确保物质的代谢运输,而不会损害视力。本文综述了人工玻璃体所需的特性,包括光特性、流变特性、膨胀力作用以及化学和物理交联水凝胶的生理和生化功能。还总结和讨论了提高水凝胶生物相容性和可注射性的策略。从临床眼科的角度来看,本文介绍了玻璃体替代的最新进展,为临床医生提供了对水凝胶临床应用的全面了解,为水凝胶的未来设计方向和方法提供了指导。