This narrative expert review covers current and emerging biomaterials in retinal surgery across five domains: vitreous tamponade agents, retinal prostheses, RPE transplant scaffolds, intraocular drug delivery platforms, and gene therapy vectors — with original preclinical data on an oxime-crosslinked hyaluronic acid vitreous substitute evaluated in rabbits.
The PRIMA photovoltaic subretinal implant improved visual acuity in 81% of geographic atrophy patients (26/32) at 12 months; a 44-channel suprachoroidal prosthesis had no device-related serious adverse events at 2.7 years; the authors' hyaluronic acid hydrogel showed a density of 1.01 g/mL, refractive index of 1.356, and IOP of 13.5–25.9 mmHg with preserved ERG in rabbits; 2025 saw approval of a refillable ranibizumab port delivery system for diabetic retinopathy and the first encapsulated cell therapy implant for macular telangiectasia type 2.
The hydrogel vitreous substitute data are preclinical (rabbit model) only; RPE scaffold trials remain in early Phase I/IIa; the review did not use systematic methodology (no PRISMA, no dual screening, no protocol registration), limiting evidence synthesis rigor.
Clinicians should be aware that retinal biomaterial innovation — from subretinal implants to sustained-release drug systems — is moving from stabilization toward tissue replacement, with several recent regulatory approvals and ongoing Phase 3 gene therapy trials reshaping the treatment landscape. Long-term safety, immunogenicity of allogeneic constructs, and scalable manufacturing remain unresolved before wider clinical adoption.
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