Vitreous tamponades are essentials used in vitrectomy procedures for healing or reattachment of retina and in vitreous dysfunction. They are majorly used in various retinal disorders such as retinal detachment, diabetic retinopathy, retinitis pigmentosa, retinal degeneration, vascular occlusion, macular hole, epiretinal membrane, macular edema, uveitis, and retinopathy of prematurity. Vitreous humor is clear and colorless fluid made up of 99% water. It occupies the space between retina and lens of the eye. Vitreous protects the eye by holding their spherical shape and helps to stay retina in place. In vitreous dysfunction, vitreous gets liquefied and shrinks in size, which eventually leads to visual impairment. As vitreous humor cannot regenerate, the cavity must be filled with substitutes by vitrectomy surgery to treat vitreous dysfunction. They are replaced with artificial substitutes, which closely resembles the native vitreous in both function and structure. The ideal vitreous substitutes should be transparent, biocompatible and elastic. Vitreous substitutes such as Semi fluorinated alkanes tamponades and silicone oil/semi fluorinated alkanes combinations are more superior physically and chemically than conventional gas or liquid tamponades. Natural polymers, hydrogel, transplant/implants, and vitreous regeneration are new vitreous substitutes in developmental stage.
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Vitreous substitutes are used as intraoperative and postoperative tool for surgical treatment of vitreoretinal disease. They are used as temporary fillers, permanent fillers or used as surgical tool during short intraocular surgery.
According to the data published by National Center for Biotechnology Information (NCBI) in January 2014, retinal detachment is the most common vision-threatening retinal condition, with an incidence of 1 in 10,000 individual annually, which corresponds to around 8,000 new cases in Germany annually. Moreover, according to the study findings by Journal of Ophthalmology in 2016, the prevalence of retinal detachment ranges from 6.3 to 17.9 per 100,000 people annually. Increasing incidences of retinal detachment, ophthalmic conditions, and retinal disease are expected to drive the growth of vitreous tamponades market in near future. However, complications associated with the conventional vitreous substitutes hamper the vitreous tamponades market growth. The intraocular gases have high risk of elevating intracellular pressure on the surrounding retinal membrane. The widely used silicone oil shows short life cycle and needs to be removed early, due to the complications such as emulsification, band keratopathy, and secondary glaucoma. Heavy silicone oil leads to significant intraocular inflammatory reactions and may cause severe complications than conventional silicone oil. Although polymer appears to be more biocompatible, they biodegrade quickly. Hence, long term biocompatibility of existing vitreous substitute material and need to develop more suitable materials is expected to replace the existing vitreous humor, in turn boosting the growth of vitreous tamponades market.
Quick filling hydrogel is expected to replace conventional vitreous tamponades in near future
According to the recent finding by the University of Tokyo in March 2017, new hydrogel-elastic gel was introduced in the vitreous tamponades market. The new hydrogel is administrated in liquid form behind the retina, which then turns into jellylike substance in just 10 minutes. The conventionally available vitreous substitute such as silicone oil and gas do not mix well with water, hence they are not suitable for long term application and require long period for gels formation, thereby making them impractical to use during the surgery. The hydrogels have high water content and composed of similar materials those found in soft tissue of eye. Conventional hydrogels absorb water and swell resulting into pressure on the surrounding retinal tissues, which eventually cause damage. The study carried out on hydrogel implanted rabbits showed no adverse effects even after 410 days of treatment.
The unique ability of newly developed hydrogel to transform into gel form in very short period and low polymer concentration makes it suitable for broader applications to treat trauma, tumors, and vitreoretinal disease. Potential development in vitreous substitutes are further expected to drive growth of the vitreous tamponades market in near future.
The major players operating in the global vitreous tamponades market includes Alcon, Inc., Carl Zeiss Meditec AG, Fluoron GmbH, D.O.R.C. Dutch Ophthalmic Research Center B.V., AL.CHI.MI.A.SRL, CROMA-PHARMA GmbH, and Valeant Pharmaceuticals International, Inc.
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