Mario Romano, MD, PhD, stresses the importance of thermodynamic control in vitrectomy

During the 2025 meeting of the European Society of Retina Specialists (EURETINA), we spoke with Mario Romano, MD, PhD, who is a professor of ophthalmology at Humanitas University in Milan, Italy. In his clinical research and his patient care, Prof Romano puts safety at the centre of his focus. "Safety is the main issue," he said, "And the point is to try to avoid any iatrogenic damage induced by surgery."

During the EURETINA congress, Prof Romano presented on thermodynamics, an often-overlooked aspect of surgical safety. Over a 10-year period, Prof Romano and colleagues have been studying the impact of temperature changes during vitrectomy. "If you have control of temperature, you have a better perfusion and [control over] the blood supply to the retina," he said. "With no temperature control...we have more damage, like the occlusion of the vessels."

Prof Romano also said that clinicians should rethink patient safety, and rely on clinical decision-making to keep patients safe, not just technical mastery. "It's not just a matter of skill," he said. "Think about what [the patient] really needs. Sometimes we don't need the vitrectomy; sometimes, we need the scleral buckle."

Watch the full video to hear him speak about a thermodynamic device currently under development, his advice for impactful surgical planning, and more.