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IMPLANTED BIOMATERIALS

A gelling vitreous replacement

Nature Biomedical Engineering volume 3, pages 590–591 (2019)Cite this article

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A rapidly gelling, biocompatible co-polymer, tested in rabbit and non-human-primate models of retinal detachment, makes for an effective replacement of the damaged vitreous.

The risk factors of retinal detachment (RD) — which has an overall incidence of 1 to 5 cases per ten thousand people, although in some patient groups it can be as high as 0.5% (one case per 200 patients) — include myopia, previous cataract surgery and severe eye injury. The impact of this condition on quality of life is serious, with only 40–50% of eyes regaining central vision (also called reading vision) following successful surgical repair of a detached retina that involves the macula. Air, expanding gases1 or silicone oil2 have been used for the treatment of RD for over five decades, with over 90% of eyes gaining retinal reattachment. However, these vitreous replacements have limitations. On the one hand, patients who have undergone vitrectomy (the surgical removal of the vitreous from the eyeball) with the use of gases have limited vision while the gas is still present, and are not allowed to fly or travel to high altitudes because of the possible expansion of gas and, therefore, the elevation of eye pressure. On the other hand, eyes receiving silicone oil need to undergo another operation after 3 to 12 months, to remove the oil. Also, silicone oil may emulsify and result in glaucoma, which often persists after oil removal. These patients typically find that the most difficult aspect of their recovery is the required constant prone positioning of the body. Hence, these patients commonly suffer from spinal discomfort, and occasionally develop elbow and ulnar nerve symptoms from the compression of the ulnar nerve during prolonged prone positioning when their arms are folded to support their head on a pillow.

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Fig. 1: Repair surgery in retinal detachment.

References

  1. Chang, S. in Retina 4th edn (ed. Ryan, S.) Ch. 127 (Elsevier, 2006).

  2. Parel, J.-M. et al. in Retina, 4th edn (ed. Ryan, S.) Ch. 129 (Elsevier, 2006).

  3. Hayashi, K. et al. Nat. Biomed. Eng. 1, 0044 (2017).

    Article  Google Scholar 

  4. Liu, Z. et al. Nat. Biomed. Eng. https://doi.org/10.1038/s41551-019-0382-7 (2019).

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Authors and Affiliations

  1. Edward S. Harkness Eye Institute, Department of Ophthalmology, Columbia University Medical Centre, New York, NY, USA

    Stanley Chang

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  1. Stanley Chang
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Correspondence to Stanley Chang.

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Chang, S. A gelling vitreous replacement. Nat Biomed Eng 3, 590–591 (2019). https://doi.org/10.1038/s41551-019-0447-7

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  • DOI: https://doi.org/10.1038/s41551-019-0447-7

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