This review critically evaluates bioadhesive materials for vitreoretinal surgery — specifically for sealing retinal breaks, macular holes, and optic disc pit maculopathy — contrasting them with conventional tamponade (gas, silicone oil) and analyzing translational barriers to clinical adoption.
No single bioadhesive platform has achieved broad clinical translation for vitreoretinal use; key barriers include poor wet-surface bonding, biomechanical mismatch with the compliant neural retina, unfavorable swelling/degradation, inflammatory or proliferative responses, and limitations in intraoperative delivery. Hydrogel-based vitreous substitutes remain investigational and provide only temporary support rather than direct defect closure.
This is a narrative review without systematic search criteria or meta-analytic pooling, so it is subject to selection bias. No original clinical trial data are presented, and most referenced bioadhesive evidence comes from preclinical or early-phase studies.
Conventional tamponade (gas, silicone oil) remains the standard for retinal stabilization; bioadhesives are not yet ready to replace it. Clinicians should view emerging vitreoretinal bioadhesives as potential *complements* to tamponade and retinopexy — aimed at focal interface sealing and biological modulation — rather than standalone substitutes.
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