Brown Andrew D, Shakarchi Ahmed F, Chauhan Muhammad Z, Chai-Chang Lindsay, Alapat Daisy, Badawi Abdulrahman H, Sallam Ahmed B
Department of Ophthalmology, Bernice and Harvey Jones Eye Institute, University of Arkansas for Medical Sciences, Little Rock, 72223, Arkansas, USA.
Department of Pathology, University of Arkansas for Medical Sciences, Little Rock, Arkansas, USA.
Int J Retina Vitreous. 2025 Aug 1;11(1):90. doi: 10.1186/s40942-025-00686-1.
Anatomically, the vitreous is not merely a transparent medium; it is a complex gel structure crucial for maintaining intraocular architecture and biochemical homeostasis. By minimizing disturbance to the vitreous, non-vitrectomized vitreous Surgery (NVS) which involves surgery with no or minimal removal of the vitreous gel, attempts to achieve the indication of the surgery while preserving the vitreous’ physiological functions, such as buffering intraocular oxygen tension and limiting the influx of inflammatory cells. This selective approach is especially relevant in younger patients with clear crystalline lenses, and in those with healthy peripheral retinas. In such cases, removing only the targeted portion of the vitreous gel or vitreoretinal interface, rather than performing a complete PPV, may reduce oxidative stress and inflammation, thereby translating to lower long-term complications such as cataract progression or peripheral retinal tears. NVS may lend itself to simple ERMs, vitreous opacities, diagnostic biopsies and localized superior rhegmatogenous retinal detachments but is not suitable for extensive vitreous or retinal pathology or advanced retinal detachment.
The online version contains supplementary material available at 10.1186/s40942-025-00686-1.
从解剖学角度来看，玻璃体不仅仅是一种透明介质；它是一种复杂的凝胶结构，对于维持眼内结构和生化稳态至关重要。通过尽量减少对玻璃体的干扰，非玻璃体切除玻璃体手术（NVS），即不切除或仅少量切除玻璃体凝胶的手术，试图在保留玻璃体生理功能（如缓冲眼内氧张力和限制炎性细胞流入）的同时实现手术指征。这种选择性方法在晶状体透明的年轻患者以及周边视网膜健康的患者中尤为重要。在这种情况下，仅切除玻璃体凝胶或玻璃体视网膜界面的目标部分，而不是进行完全的玻璃体后脱离手术（PPV），可能会减少氧化应激和炎症，从而降低白内障进展或周边视网膜裂孔等长期并发症的发生率。NVS可能适用于简单的视网膜前膜、玻璃体混浊、诊断性活检和局限性上方孔源性视网膜脱离，但不适用于广泛的玻璃体或视网膜病变或晚期视网膜脱离。
在线版本包含可在10.1186/s40942-025-00686-1获取的补充材料。
