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Subretinal Implant: Surgery and Long-term Follow-up
1Gabel V.-P., 1Sachs H., 1Kobuch K., 2Kohler K., 3Hämmerle H. D., 4Zrenner E.,
1Universität Regensburg, Klinik und Poliklinik für Augenheilkunde (Regensburg)
2Eberhard-Karls-Universität Tübingen, Universitäts-Augenklinik, Forschungsstelle für experimentelle Ophthalmology (Tübingen)
3Naturwissenschaftliches und Medizinisches Institut (Reutlingen)
4Eberhard-Karls-Universität Tübingen, Universitäts-Augenklinik, Abt. II, Pathophysiologie des Sehens u. Neuroophthalmologie (Tübingen)
Aim: To develop surgical procedures for implantation of subretinal prosthesis.
Methodes and Results: The early types of MPD consisted of 2 - 3 mm diameter silicon discs and could be implanted by two ways ab interno through pars plana and a retinotomy and ab externo through a scleral flap and chorioid. The clinical follow up up to 29 month by ophthal-moscopy, fluoresceinangiography and OCT revealed stable position of the implants without any pathological adverse reaction and complete attachment of the overlaying retina. This has been proven also by histology. As an intermediate step for determination of the parameters of the stimulation it was necessary to implant wirebound stimulation devices which was achieved surgically in the same ways. Meanwhile the electronic devices became more sophisticated and require additional energy to generate sufficient stimulation and by that those devices became significantly bigger up to 3 x 25 mm. The implan-tation of these new devices needed a more complex procedere by a combined internal and external access at the same time, allowing that part of the required electronic attached to the foil can be located epi-sclerally. It has been also shown that also explantation of the devices is possible and can be achieved in the same way.
Conclusions: The combined surgical procedure has been proven quite satisfactory for one year in laboratory animals giving rise to the hope that it may be successfully applicable in human beeings as well.
Supported by BMBF No. 01KP0012