Retinal Tamponades: Current Uses and Future Technologies
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RETINA (R GOLDHARDT, SECTION EDITOR)
Retinal Tamponades: Current Uses and Future Technologies Avnish Deobhakta 1 & Richard Rosen 1
# Springer Science+Business Media, LLC, part of Springer Nature 2020
Abstract Purpose of Review In this article, the current use and limitations of existing retinal tamponades are discussed. Potential novel developments that address those limitations are subsequently highlighted, along with areas of future improvements. Recent Findings While retinal tamponades have existed for decades and improved the treatment of retinal detachments, many problems still exist with their use, including inadequate tamponade of the inferior retina, toxicity from retained heavy liquids, glaucoma, and keratopathy, among others. New advancements in the components of heavy liquids and vitreous substitutes aim to mitigate those issues. Summary Existing retinal tamponades, including perfluorocarbon heavy liquids, fluorinated gases, and silicone oil, have specific limitations that cause potentially avoidable morbidity. New developments, such as heavy silicone oil, novel vitreous gels, and future avenues of approach, such as potentially reabsorbing heavy liquids may help increase our ability to treat retinal detachments with fewer complications. Keywords Retinal detachment . Vitreous . Tamponade . Perfluorocarbon liquid . Silicone oil . Heavy fluid
Introduction Retinal detachments are a leading cause of emergent permanent blindness worldwide, with a geographically varying incidence ranging from 6 to 18 individuals per 100,000 in the population [1]. Given the relatively rapid onset of this disease, its repair has been a source of investigation for over a century [2, 3]. With improvements in surgical techniques and instrumentation, the primary reattachment rate has increased from less than 1% without intervention to approximately 90% in the present day [4–6]. However, significant morbidity often remains, particularly with inferior retinal detachments, which are prone to re-detachments and carry a relatively increased risk of eventual blindness [7]. The current surgical paradigm of reattachment involves the use of intraoperative heavy liquid This article is part of the Topical Collection on Retina * Avnish Deobhakta [email protected] Richard Rosen [email protected] 1
Department of Ophthalmology, New York Eye and Ear Infirmary of Mount Sinai Icahn School of Medicine, Mount Sinai, New York, NY, USA
tamponades and postoperative gases or oils, the latter of which function in effect as longer-term vitreous substitutes [8, 9]. While effective, each one of these agents carries its own list of drawbacks, which ultimately leads to many of the subsequent complications seen during and after retinal detachment repair. The purpose of this paper is to explain the current use of these tools, identify their disadvantages, and explore potential solutions to those issues, many of which are currently being developed.
Existing Commonly Used Tamponades In the context of retinal detachment repair, the ultimate purpose of a retinal
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