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Replacing the vitreous body with hydrogels: Rationale and strategies.

André Schulz¹, Meghal Keskar², Katelyn E Swindle-Reilly³

¹Department of Ophthalmology, Rostock University Medical Center, Rostock, Germany.

Progress in Retinal and Eye Research

|July 11, 2025

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Hydrogels show promise as vitreous substitutes, mimicking natural vitreous properties for ocular homeostasis after vitreoretinal surgery. Further research aims to develop ideal vitreous substitutes with enhanced biocompatibility and drug delivery capabilities.

Area of Science:

Ophthalmology
Biomaterials Science
Regenerative Medicine

Background:

The native vitreous does not regenerate, necessitating replacement after vitreoretinal surgery.
Current vitreous substitutes (gases, silicone oils) have significant limitations and complications.
Hydrogels are being investigated as superior vitreous substitutes due to their biocompatibility and similarity to native vitreous.

Purpose of the Study:

To provide a comprehensive review of vitreous substitutes.
To discuss the challenges of current substitutes and advancements in hydrogel technology.
To explore future opportunities for ideal vitreous substitutes, including drug delivery and cellularization.

Main Methods:

Literature review of structural and biochemical properties of the vitreous.

Keywords:

Gas Hyalocyte Hydrogel Silicone oil Vitreoretinal surgery Vitreous Vitreous substitute

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Analysis of existing vitreous substitutes and their clinical limitations.

Evaluation of preformed and in-situ forming hydrogels (biopolymer and synthetic) for vitreous replacement.

Main Results:

Hydrogels offer promising optical, mechanical, and biochemical properties for vitreous substitution.
Both preformed and in-situ forming hydrogels demonstrate potential for clinical application.
Challenges remain in achieving long-term biocompatibility and replicating all native vitreous functions.

Conclusions:

Hydrogels represent a significant advancement in the development of vitreous substitutes.
Future research should focus on optimizing hydrogel properties and exploring advanced applications like drug delivery and cellularization.
The development of ideal vitreous substitutes is crucial for improving outcomes in vitreoretinal surgery.