June 2020
Volume 61, Issue 7
ARVO Annual Meeting Abstract  |   June 2020
The challenge to meet the expectations of patients, ophthalmologists and public health care systems with current retinal prostheses
Author Affiliations & Notes
  • Eberhart Zrenner
    Institute for Ophthalmic Research, Centre for Ophthalmology, Tuebingen, Germany
  • Alfred Stett
    Retina Implant AG, Reutlingen, Germany
  • Reinhard Rubow
    Retina Implant AG, Reutlingen, Germany
  • Footnotes
    Commercial Relationships   Eberhart Zrenner, EyeServ GmbH (R), Retina Implant AG (S); Alfred Stett, Okuvision GmbH (S), Retina Implant AG (S); Reinhard Rubow, Retina Implant AG (R)
  • Footnotes
    Support  Grant from Retina Implant AG, Reutlingen, Germany
Investigative Ophthalmology & Visual Science June 2020, Vol.61, 2214. doi:
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      Eberhart Zrenner, Alfred Stett, Reinhard Rubow; The challenge to meet the expectations of patients, ophthalmologists and public health care systems with current retinal prostheses. Invest. Ophthalmol. Vis. Sci. 2020;61(7):2214.

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

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Purpose : The manufacturing of the subretinal Retina Implant ALPHA AMS (Retina Implant AG, Reutlingen Germany) and of the epiretinal implant ARGUS II (Second Sight, Sylmar CA, USA), the only two implants so far available for patients, has been discontinued in 2019, despite the fact that many of the patients who had received such implants (72 with ALPHA AMS and >350 patients with ARGUS II) had some restitution of vision useful for daily living tasks. Reasons for such developments are presented here.

Methods : Comments were collected and analyzed from blind patients, ophthalmologists, hospital controllers and health insurance providers who were interested in or had to deal with electronic retinal implant ALPHA AMS.

Results : 1. Expectations of most candidates for electronic implants concerning quality of vision cannot be met. Improvements of visual functions by today’s electronic implants are considered as too small. Only a fraction of patients (40%-50%) had benefit in typical daily living tasks (K. Stingl et al. 2015, 2017); preoperatively the degree of individual vision improvement cannot be predicted.
2. Regulatory processes take too long in implementing lab-tested technical improvements into modified approved devices.
3. Achieving coverage of costs by health care insurance systems is cumbersome in each and every country.
4. Alternative solutions are provided by the rapidly increasing number of convenient and easy to handle smartphone Apps.

Conclusions : Continued availability of electronic retinal implants needs considerable improvements of function and handling to meet the expectations of patients, ophthalmologists and health care insurances: larger visual fields, higher spatial resolution, improved contrast, higher number of simultaneously discernible grey levels, coding of isoluminant chromatic information and faster surgical procedures. Equally important are constructions that provide long-term stable and reliable perceptions and maintain normal facial appearance. Also a strong focus on the development of appropriate visual rehabilitation techniques and technical integration of recognition software is required. Nevertheless continuing care for patients who have received retinal implants in recent years will be provided by clinical partners and research for improvements will go on in our labs with preclinical work on more advanced implant models meanwhile developed.

This is a 2020 ARVO Annual Meeting abstract.


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