Novel Vitreous Substitutes in Animal and Human Models: A Systematic Review.

INTRODUCTION

Vitreous substitutes are crucial adjuncts during vitreoretinal surgery for retinal detachment, macular holes, and vitreous hemorrhage. However, current vitreous substitutes pose limitations, including but not limited to their postoperative decrease in visual sharpness, nonfavorable refractive indices, and complications such as glaucoma, cataract, and retinal toxicity.

METHODS

We conducted a systematic review to evaluate the biological, physical, and clinical properties of novel experimental vitreous substitutes in animal and human models. We performed a systematic search on Ovid Medline, Embase, and Scopus from January 1, 1990, to October 10, 2025. Studies were included if they reported on any of the following three aspects: optical properties, biological interactions, or clinical outcomes.

RESULTS

Out of 11,045 search results, 37 studies investigating novel hydrogels (n = 15), polymers (n = 5), liquids (n = 5), and devices (n = 12) were included. Among these, 16/37 substitutes had > 80% success in tamponade of retinal detachments, 12/37 showed high tissue biocompatibility, 15/37 demonstrated low ocular inflammation, 13/37 exhibited optical properties similar to native vitreous, and 14/37 were associated with no significant changes in intraocular pressure.

CONCLUSIONS

Novel experimental vitreous substitutes, such as UV-CHA, Vitargus ABV-1701, PanaceaGel SPG-178, E10KDC18, or FCVB, show the most promising biological, optical, and physical properties for additional investigation as vitreous substitutes.