March 2012
Volume 53, Issue 14
ARVO Annual Meeting Abstract  |   March 2012
Subretinal Implants: Optimization Of Surgical Technique Without Silicone Oil And Postoperative Intraocular Corrections
Author Affiliations & Notes
  • Florian Gekeler
    Centre for Ophthalmology, Tuebingen Univ Eye Hosp, Tuebingen, Germany
  • Helmut G. Sachs
    Eye Clinic, Klinikum Dresden Friedrichstadt, Dresden, Germany
  • Dorothea Besch
    Centre for Ophthalmology, Tuebingen, Germany
  • Assen Koitschev
    Olgahospital, Stuttgart, Germany
  • Katarina Stingl
    Ophthalmology, University Hospital Tuebingen, Tuebingen, Germany
  • Stephanie Hipp
    Centre for Ophthalmology, Tuebingen Univ Eye Hosp, Tuebingen, Germany
  • Eberhart Zrenner
    Institute for Ophthalmic Research,
    Centre for Ophthalmology, Tuebingen, Germany
  • Karl Ulrich Bartz-Schmidt
    Centre for Ophthalmology, Tuebingen, Germany
  • Footnotes
    Commercial Relationships  Florian Gekeler, Retina Implant AG (F, C); Helmut G. Sachs, Retina Implant AG (F); Dorothea Besch, Retina Implant AG (F); Assen Koitschev, None; Katarina Stingl, Retina Implant AG (F); Stephanie Hipp, Retina Implant AG (F); Eberhart Zrenner, Retina Implant AG (F, I, C, P); Karl Ulrich Bartz-Schmidt, Retina Implant AG (F)
  • Footnotes
    Support  None
Investigative Ophthalmology & Visual Science March 2012, Vol.53, 5532. doi:
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      Florian Gekeler, Helmut G. Sachs, Dorothea Besch, Assen Koitschev, Katarina Stingl, Stephanie Hipp, Eberhart Zrenner, Karl Ulrich Bartz-Schmidt; Subretinal Implants: Optimization Of Surgical Technique Without Silicone Oil And Postoperative Intraocular Corrections. Invest. Ophthalmol. Vis. Sci. 2012;53(14):5532.

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      © ARVO (1962-2015); The Authors (2016-present)

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Purpose: : Surgery for active subretinal implants has been well established during the last 6 years with safe and stable implantations in 21 patients with retinitis pigmentosa (RP). Surgical focus can now be on post-operative interventions to maximize visual outcome by small adjustments of implant position and on potential improvements such as omission of any endotamponade.

Methods: : 21 patients with RP underwent implantation of a subretinal active implant (Retina Implant AG, Germany). - 2 patients underwent subsequent minimal adjustment of the subretinal position to maximize the area under the macula in an attempt to optimize visual performance. - 1 patient underwent silicone oil exchange with subretinal rtPA 1 week after implantation for subretinal hemorrhage from a postoperative retinal break stemming from retinal injury by the polyimide foil. - 1 patient received only BSS as endotamponade, whereas all other patients had received silicone oil.

Results: : All interventions were performed without complications, resulting in the desired chip position and resolution of hemorrhage, respectively; the device remained completely unharmed and functional in all cases. Adjustments of position required neither oil exchange nor other intraocular maneuvers. Retinal integrity was maintained in all cases. - The patient with BSS endotamponade showed attached retina without hemorrhage throughout the postoperative course. - Grating acuity (GA) changed from 0.3 to 1 cpd and from unmeasurable to 0.3 cpd in the cases with position adjustments; GA reached 3.3. cpd in the patient with hemorrhagic episode and 0.33 in the patient without endotamponade (data in the latter only available in the first postoperative week).

Conclusions: : Postoperative interventions to adjust the subretinal implant position for optimization of visual function are feasible and can markedly improve visual function. Complications such as a subretinal hemorrhage can be successfully managed. The results in the first patient without silicone oil endotamponade show potential advantages; future evaluation will have to clarify this surgical option.

Clinical Trial: : NCT01024803

Keywords: retinitis • retinal degenerations: hereditary 

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