Vitreous substitute and tamponade substances for microincision vitreoretinal surgery

Intraocular tamponades are important tools in vitreoretinal surgery and their introduction has represented a pivotal moment in the management of ophthalmic surgery as they are equipped with a combination of chemical and physical properties that have propelled their surgical use. There are two ophthalmic tamponades, liquid and gas, both of which are currently used in microincision vitreoretinal surgery (MIVS).

Perfluorocarbon liquids (PFCLs) are effective in a wide range of situations, not only for repair of complex retinal detachment, but also for a variety of intraocular surgical maneuvers since they have physical properties that render them very useful for vitreoretinal surgeons. These include transparency, high specific gravity, and immiscibility with water. Thanks to their low viscosity, PFCLs are easy to use with MIVS. The intraocular gases are important tools used primarily for the ability to provide internal tamponade for retinal tears or holes. Performing oblique sclerotomy has overtaken the risk of postoperative hypotony. Silicon oil (SO) describes a group of hydrophobic polymeric and monomeric compounds made up of silicon-oxygen bonds, which have the capability to be lighter or heavier than water (heavy SO). In MIVS there is an increase in the use of SO with lower viscosity.

Intraocular tamponades are very useful surgical tools because they have simplified the surgical management of many vitreoretinal diseases. With modern vitrectomy systems, the possibility to use different tamponade substances has improved the prognosis of several diseases.