May 2006
Volume 47, Issue 13
Free
ARVO Annual Meeting Abstract  |   May 2006
A Modified Method for Ab Externo, Sub–Retinal Prosthetic Implantation
Author Affiliations & Notes
  • J. Chen
    Department of Ophthalmology, Massachusetts Eye and Ear Infirmary, Harvard Medical School, Boston, MA
  • L. Snebold
    Department of Ophthalmology, Massachusetts Eye and Ear Infirmary, Harvard Medical School, Boston, MA
  • M. Kenney
    Department of Ophthalmology, Massachusetts Eye and Ear Infirmary, Harvard Medical School, Boston, MA
  • J. Brookman
    Department of Ophthalmology, Massachusetts Eye and Ear Infirmary, Harvard Medical School, Boston, MA
  • J.F. Rizzo, III
    Department of Ophthalmology, Massachusetts Eye and Ear Infirmary, Harvard Medical School, Boston, MA
    The Center for Innovative Visual Rehabilitation, VA Medical Center, Boston, MA
  • Boston Retinal Implant
    Department of Ophthalmology, Massachusetts Eye and Ear Infirmary, Harvard Medical School, Boston, MA
  • Footnotes
    Commercial Relationships  J. Chen, None; L. Snebold, None; M. Kenney, None; J. Brookman, None; J.F. Rizzo, None.
  • Footnotes
    Support  Department of Veteran Affairs Center of Excellence Grant
Investigative Ophthalmology & Visual Science May 2006, Vol.47, 3190. doi:
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      J. Chen, L. Snebold, M. Kenney, J. Brookman, J.F. Rizzo, III, Boston Retinal Implant; A Modified Method for Ab Externo, Sub–Retinal Prosthetic Implantation . Invest. Ophthalmol. Vis. Sci. 2006;47(13):3190.

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

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Abstract

Purpose: : To develop a more well–controlled method to implant a relatively large electrode array into the sub–retinal space.

Methods: : Fourteen eyes of Yucatan miniature pigs were studied under inhalation anesthesia. To control excessive bleeding, "controlled" hypotension (30 – 45mmHg) was maintained by IV nitroprusside. A partial thickness scleral flap (up to 8 x 6 mm) was dissected 5 mm posterior to the limbus super–temporally. To lower intra–ocular pressure, significant vitrectomy was performed in all eyes, and anterior chamber paracentesis was performed in two eyes. Then, scleral fibers were shaved away to expose the choroid; a choroidectomy was made by tenting the choroid with a forceps and removing the tissue with a scissors. In 4 eyes, Healon was injected through a choroidotomy into the sub–retinal space to separate the choroid and retina. An inactive, gold–wired polyimide strip was placed onto the retina and the scleral flap was sutured.

Results: : In 4 eyes, the surgery failed because of a significant choroidal hemorrhage and retinal tear. In 7 eyes, a large area of retina (> 6 x 3 mm) was exposed and an array was successfully implanted in 5 of these eyes (In the other 2 eyes, an area of retina was exposed but the eye collapsed thereafter because of marked ocular hypotonia). In 3 eyes, the area of exposed retina was not large enough for the 1.5 mm wide electrode array.

Conclusions: : More work is needed to develop this technique, but this procedure is a viable alternative method for prosthetic implantation because this procedure is more controlled (i.e. the retina and array can be easily visualized at the same time) and less invasive (i.e. it does not require making a retinotomy and creating a retinal bleb) than our current method.

Keywords: retina • vitreoretinal surgery • choroid 
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