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P. O. Barale, S. Mohand Said, S. Ayello-Scheer, J.-A. Sahel; Argus Tm II Epiretinal Prosthesis : Paris Experience and an Improved Surgical Technique. Invest. Ophthalmol. Vis. Sci. 2010;51(13):3048.
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We have developed a novel surgical technique for the Second Sight Argus II epiretinal prosthesis which is intended to avoid hypotonia.
Four patients with advanced retinitis pigmentosa were implanted between January 2008 and May 2009 at Quinze vingts hospital in Paris. A 60-electrode implant developed by Second Sight Medical Products, Inc. was fixed on the retina. Postoperative clinical follow up and functional tests were performed weekly.
The immediate and medium postoperative periods were without major complications. Tolerance of the intraocular prosthesis was demonstrated after several months of monitoring. All patients showed improvement of their visual performance after an initial learning period.One patient (the first) did experience ocular hypotony with choroidal detachment, which resolved in 30 days without treatment. This first case led us to change our surgical technique. In the first case, the implant was inserted through a direct sclerotomy and then covered by a synthetic scleral patch. In the following three cases, we performed a scleral flap on the sclerotomy site, and covered the implant with an autologous transplant of temporal fascia. With this new technique, our three next cases did not present hypotonia.
The Argus II implant is well tolerated over the medium-term. Our patients have expressed a subjective improvement of their visual perception whch has been confirmed by visual tests performed in the clinic. We have also proposed a new surgical technique in the prosthesis implantation to avoid postoperative hypotonia.
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