Implantation of Modular Photovoltaic Subretinal Prosthesis

Lee, Dae Yeong; Lorach, Henri; Huie, Phil; Palanker, Daniel

doi:10.3928/23258160-20160126-11

Cited by 27 publications

(18 citation statements)

References 9 publications

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“…Therefore, an implant can consist of a large number of independent modules that tile the visual field. These modules can be inserted into the subretinal space via a small incision and follow the curvature of the eye, making the surgery minimally-traumatic [53]. …”

Section: Approaches To Retinal Prostheticsmentioning

confidence: 99%

Electronic approaches to restoration of sight

Goetz

Palanker

2016

Rep. Prog. Phys.

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Retinal prostheses are a promising means for restoring sight to patients blinded by the gradual atrophy of photoreceptors due to retinal degeneration. They are designed to reintroduce information into the visual system by electrically stimulating surviving neurons in the retina. This review outlines the concepts and technologies behind two major approaches to retinal prosthetics: epiretinal and subretinal. We describe how the visual system responds to electrical stimulation. We highlight major differences between direct encoding of the retinal output with epiretinal stimulation, and network-mediated response with subretinal stimulation. We summarize results of pre-clinical evaluation of prosthetic visual functions in- and ex-vivo, as well as the outcomes of current clinical trials of various retinal implants. We also briefly review alternative, non-electronic, approaches to restoration of sight to the blind, and conclude by suggesting some perspectives for future advancement in the field.

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Section: Approaches To Retinal Prostheticsmentioning

confidence: 99%

Electronic approaches to restoration of sight

Goetz

Palanker

2016

Rep. Prog. Phys.

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“…Retinal degenerative diseases such as retinitis pigmentosa and macular degeneration lead to irreversible damage or even loss of photoreceptors, which can result in serious impairment of vision and eventually blindness 10 , 11 . The state-of-art retinal prosthesis devices require the use of a subretinally placed photodiode array detecting near-infrared signals from a video capturing camera 12 , 13 . Recently, developing light-responsive materials as artificial photoreceptors for interfacing with blind retinas has emerged as a promising alternative for retinal prosthesis, with several exciting preliminary demonstrations using metal electrode arrays 14 , cadmium sulfide-carbon nanotubes 15 , semiconductor silicon photodiodes 16 or conducting polymers 17 – 19 .…”

Section: Introductionmentioning

confidence: 99%

Nanowire arrays restore vision in blind mice

et al. 2018

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The restoration of light response with complex spatiotemporal features in retinal degenerative diseases towards retinal prosthesis has proven to be a considerable challenge over the past decades. Herein, inspired by the structure and function of photoreceptors in retinas, we develop artificial photoreceptors based on gold nanoparticle-decorated titania nanowire arrays, for restoration of visual responses in the blind mice with degenerated photoreceptors. Green, blue and near UV light responses in the retinal ganglion cells (RGCs) are restored with a spatial resolution better than 100 µm. ON responses in RGCs are blocked by glutamatergic antagonists, suggesting functional preservation of the remaining retinal circuits. Moreover, neurons in the primary visual cortex respond to light after subretinal implant of nanowire arrays. Improvement in pupillary light reflex suggests the behavioral recovery of light sensitivity. Our study will shed light on the development of a new generation of optoelectronic toolkits for subretinal prosthetic devices.

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“…1 ) (see Supplementary Video S7 online). For this reason, a machine-driven fluid-stream injection approach with a 41-gauge cannula was successfully adopted instead 32 . This method is useful but requires a 41-gauge cannula connected to the silicone oil infusion pump of a vitrectomy machine to support a controllable, steady, and stable procedure.…”

Section: Discussionmentioning

confidence: 99%

“…However, current methods for subretinal surgery as well as ab-interno subretinal implantation have not been widely taught to current-generation retinal surgeons, with subretinal surgical approaches being more widely discussed and published on in the late 1990s and early 2000s 30 , 31 . Although ab-interno surgery for subretinal implantation is easier than ab-externo surgery 24 , 32 , this surgical procedure still requires an experienced operator and involves the conduct of inconvenient procedures using additional instruments, such as connecting a 41-gauge cannula to the vitrectomy machine.…”

Section: Introductionmentioning

confidence: 99%

Ab-interno surgical technique for the implantation of a wireless subretinal prosthesis in mini-pigs

Choi

Anh

Seo

et al. 2020

Sci Rep

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We sought to describe the surgical techniques required in the ab-interno method to implant subretinal prostheses in mini-pigs and suggest tips to facilitate optimal outcomes. During vitrectomy, the use of valved trocar cannulas was essential to stabilize the detached retina and implanted chip. As a first step in retinal detachment, a 23-gauge cannula with very small amount of viscoelastic material was used to establish the retinal hole and promote retinal detachment. Then, balanced salt solution was applied to increase the retinal detachment and diathermy was used to make opening for subretinal prosthesis. For easy positioning of the subretinal prosthesis, a curved laser probe was adopted when handling the subretinal prosthesis under the retina. After surgery, the sclerotomy sites were tightly sutured to prevent silicone oil leakage. Without special equipment, such as a 41-gauge tip, retinal detachment could be induced easily, while the prosthesis was also successfully inserted and manipulated under the retina without an iatrogenic retinal tear. Two weeks after the operation, the oil fully occupied the intraocular volume without leakage. The subretinal prosthesis remained stable without complication. Understanding the principle of the ab-interno method and considering several tips for improving surgical access may help to enhance surgical success rates of subretinal prostheses implantation.

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Implantation of Modular Photovoltaic Subretinal Prosthesis

Cited by 27 publications

References 9 publications

Electronic approaches to restoration of sight

Electronic approaches to restoration of sight

Nanowire arrays restore vision in blind mice

Ab-interno surgical technique for the implantation of a wireless subretinal prosthesis in mini-pigs

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