Vitreoretinal bioadhesives: Translational challenges and innovative perspectives

Area of Science:

• Ophthalmology
• Biomaterials Science
• Regenerative Medicine

Background:

• Bioadhesives are used in ophthalmology but limited in vitreoretinal surgery.
• Current methods like gas/silicone oil tamponade offer temporary support, not direct defect closure.
• Barriers include poor wet-surface bonding, vitreous remnants, biomechanical mismatch, and delivery issues.

Purpose of the Study:

• To critically reappraise vitreoretinal bioadhesive strategies for retinal detachment and defect repair.
• To integrate clinical evidence with adhesion engineering for a translational perspective.
• To outline design principles for next-generation vitreoretinal bioadhesives.

Main Methods:

• Problem-driven, retina-centered framework.
• Integration of clinical vitreoretinal evidence and adhesion engineering principles.
• Barrier-oriented translational perspective for interface-directed retinal repair.

Main Results:

• Next-generation bioadhesives require indication-specific functions beyond adhesion strength.
• Design should consider controlled persistence, intraoperative deliverability, and compatibility with secondary surgeries.
• Future bioadhesives may act as precision platforms complementing existing treatments.

Conclusions:

• Vitreoretinal bioadhesives need tailored designs for specific indications, moving beyond simple adhesion.
• Overcoming posterior-segment barriers is crucial for successful clinical translation.
• A mechanism-informed roadmap is proposed for developing and translating these advanced materials.