In retinal detachment surgery it is essential to ensure close apposition between the detached retina and the adjacent choroid and sclera. Adequate drainage of the subretinal fluid is first necessary to permit this apposition. In order to maintain it, air, saline, cerebrospinal fluid, and other substances have been used. Unfortunately, these substances are all absorbed within a few hours or days. Shafer's introduction of the use of vitreous1-3 for this purpose has the merit that vitreous is not absorbed, so that it acts as a permanent internal splint bracing the retina against the choroid and sclera.
Vitreous contains protein and should serve as an excellent culture medium. It is at body temperature and contains no blood vessels able to transmit antibodies and inflammatory cells to the site of infection with rapidity. It has, therefore, always been considered to have a low resistance to infection.
Since Shafer's first report in
REED H, WILT JC, TUSHINGHAM G. A Preliminary Report on the Self-Sterilizing Property of Vitreous. AMA Arch Ophthalmol. 1958;60(3):361-365. doi:10.1001/archopht.1958.00940080377003