Biological and therapeutic aspects of proliferative vitreoretinopathy

Conventional vitreoretinal surgery for proliferative vitreoretinopathy is unsatisfactory despite numerous innovations over the past 20 years. Silicone oil injections in this series resulted in 70% reattachment of these end-stage cases, but within twelve months over 90% had no useful visual result. The development of an in vitro model for 3-dimensional culture of cells has allowed evaluation of numerous potential drugs with anti-proliferative or anti-contractile activities. Amongst these, taxol has shown the most promise. There remain, however, doubts about possible long-term toxicity to the optic nerve and retina. It is concluded that a more physiological vitreous substitute and more specific anti-proliferative or anti-contractile pharmacological agents are needed.