Towards the bionic eye — the retina implant: surgical, opthalmological and histopathological perspectives

Alteheld, Nils; Roessler, Gernot; Walter, Peter

doi:10.1007/978-3-211-33081-4_56

Cited by 20 publications

(12 citation statements)

References 35 publications

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“…This suggests -in accordance with a number of prior studies -biocompatibility of the materials used for encapsulation and electrode surface [11,[21][22][23] .…”

Section: Discussionsupporting

confidence: 88%

Surgical Results and Microscopic Analysis of the Tissue Reaction following Implantation and Explantation of an Intraocular Implant for Epiretinal Stimulation in Minipigs

et al. 2011

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Aims: For the purpose of visual rehabilitation of subjects with photoreceptor degeneration, an implantable microelectronic device for epiretinal stimulation was developed. Our study aimed to show whether implantation and explantation could be conducted safely and to investigate tissue compatibility. Methods: The device was implanted in 5 Göttinger minipigs. Four weeks later, the implant was surgical- ly removed. Histopathological examination that followed aimed at detecting inflammatory or proliferative changes. Stains used were hematoxylin and eosin, leukocyte common antigen, CD68 and glial fibrillary acidic protein. A grinding technique was used to visualize the retinal tissue in conjunction with the retinal tacks. Results: The implantation of the devices was successful in all cases. The explantation was complicated by intraoperative hemorrhages. Complete explantation could only be achieved after modifying the implantation strategy. Histopathology revealed a mild degree of cystic disaggregation of the retina. Immunohistochemically, an increased glial fibrillary acidic protein expression of Müller cells was found, which shows a moderate glial cell activation. Inflammatory cells were absent. Using the grinding technique, tissue adjacent to the retinal tacks showed a mild gliosis. Discussion: The viability of implantation and explantation of the implant in minipigs has been shown. The absence of immunoreactive cells or a considerable glial reaction suggest that the device may be considered safe and suitable for further implantation in humans.

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“…This suggests -in accordance with a number of prior studies -biocompatibility of the materials used for encapsulation and electrode surface [11,[21][22][23] .…”

Section: Discussionsupporting

confidence: 88%

Surgical Results and Microscopic Analysis of the Tissue Reaction following Implantation and Explantation of an Intraocular Implant for Epiretinal Stimulation in Minipigs

et al. 2011

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“…To overcome this transcutaneous cable connection, the receiver of a wireless system has been either placed subcutaneously in the retro-auricular space,21 episclerally22 or even intraocularly as a modified intraocular lens in the capsular bag 23. Even when using up-to-date technology, a totally intraocularly implantable device is still large, and the trauma inferred for implantation is considerable, since it requires a large limbal opening and combined anterior and posterior segment surgery with a wired connection, for example from the capsular bag to the episcleral surface,23 or possibly even to the subretinal space.…”

Section: Discussionmentioning

confidence: 99%

“…Even when using up-to-date technology, a totally intraocularly implantable device is still large, and the trauma inferred for implantation is considerable, since it requires a large limbal opening and combined anterior and posterior segment surgery with a wired connection, for example from the capsular bag to the episcleral surface,23 or possibly even to the subretinal space. The easier surgical access and the additional room in the extraocular space give more freedom in choice for the receiver coils and control circuitry.…”

Section: Discussionmentioning

confidence: 99%

Extraocular surgery for implantation of an active subretinal visual prosthesis with external connections: feasibility and outcome in seven patients

Besch

Sachs

Szurman

et al. 2008

British Journal of Ophthalmology

105

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Background: Due to low energy levels in microphotodiode-based subretinal visual prostheses, an external power supply is mandatory. We report on the surgical feasibility and the functional outcome of the extraocular part of an approach to connect a subretinal prosthesis to an extracorporeal connector in the retro-auricular space via a trans-scleral, transchoroidal cable. Methods: Seven volunteers with retinitis pigmentosa received an active subretinal implant; energy was supplied by gold wires on a trans-sclerally, transchoroidally implanted polyimide foil leading to the lateral orbital rim where it was fixated and connected to a silicone cable. The cable was implanted subperiostally beneath the temporal muscle using a trocar to the retroauricular space where it penetrated the skin for connection to a stimulator. To avoid subretinal movement of the implant, three tension relief points have been introduced. Results: All implantations were performed as planned without complications, and no serious adverse events occurred in the postoperative period. Fixation of the implants was stable throughout the entire study duration of 4 weeks; permanent skin penetration proved to be uncomplicated. Motility was minimally restricted in downgaze and ab-/adduction. Explantation was uneventful. Conclusion: The above-described procedure provides a method for stable fixation of a subretinal device with a trans-scleral, transchoroidal cable connection to an extracorporeal connector.Retinal implants elicit visual perceptions by electrical stimulation of retinal cells.

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“…In 2007, Alteheld and colleagues compiled a review to report on the developments of visual implants [ 76 ]. Electrical stimulation of the retina of blind subjects resulted in ambulatory vision (allowed movements without collisions and stumbling) and some character recognition.…”

Section: Implantable Devicesmentioning

confidence: 99%

Nanotechnology in Advanced Medical Devices

Habib-Ullah

Fei

2014

Nanomedicine

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Towards the bionic eye — the retina implant: surgical, opthalmological and histopathological perspectives

Cited by 20 publications

References 35 publications

Surgical Results and Microscopic Analysis of the Tissue Reaction following Implantation and Explantation of an Intraocular Implant for Epiretinal Stimulation in Minipigs

Surgical Results and Microscopic Analysis of the Tissue Reaction following Implantation and Explantation of an Intraocular Implant for Epiretinal Stimulation in Minipigs

Extraocular surgery for implantation of an active subretinal visual prosthesis with external connections: feasibility and outcome in seven patients

Nanotechnology in Advanced Medical Devices

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