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[The need for pharmacology in vitreoretinal surgery SOE Lecture 2007]
1Vitreoretinal and Pathology Unit, Augenklinik der Ludwig-Maximilians-Universität München. arnd.gandorfer@med.uni-muenchen.de
Background:
While the limits of mechanical vitrectomy are being approached, scientists and vitreoretinal surgeons are looking for a combination of pharmacology and vitrectomy, i. e., pharmacology-assisted vitrectomy.
Methods:
This review shows the limits of conventional vitreoretinal surgery by presenting clinical and ultrastructural data related to vitreoretinal surgical techniques and outcomes.
Results:
The limits of conventional vitreoretinal surgery include: 1. Incomplete vitreous cortex removal. 2. Surgery of advanced stages of the disease. 3. The lack of neuroprotection and antiproliferative agents. 4. Ill-defined cleavage planes when removing tissue from the retina.
Conclusions:
Pharmacology-assisted vitrectomy helps to overcome the limits of conventional vitreoretinal surgery by addressing: Item 1. Pharmacological vitreolysis. Item 2. Earlier, less traumatic intervention. Item 3. Neuroprotection and antiproliferative agents. Item 4. Selective staining of distinct structures of the vitreoretinal interface, such as cortical vitreous, cellular proliferation, and internal limiting membrane.
