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Br J Ophthalmol 2008;92:1361-1368 doi:10.1136/bjo.2007.131961
  • Original Article

Extraocular surgery for implantation of an active subretinal visual prosthesis with external connections: feasibility and outcome in seven patients

  1. D Besch1,
  2. H Sachs2,
  3. P Szurman1,
  4. D Gülicher3,
  5. R Wilke1,
  6. S Reinert3,
  7. E Zrenner1,
  8. K U Bartz-Schmidt1,
  9. F Gekeler1
  1. 1
    Centre for Ophthalmology, University of Tübingen, Tübingen, Germany
  2. 2
    Department of Ophthalmology, University of Regensburg, Regensburg, Germany
  3. 3
    Department of Oral and Maxillofacial Surgery, University of Tübingen, Tübingen, Germany
  1. Dr F Gekeler, Centre for Ophthalmology, University of Tübingen, Schleichstraße 12–16, 72076 Tübingen, Germany; gekeler{at}uni-tuebingen.de
  • Accepted 15 July 2008
  • Published Online First 28 July 2008

Abstract

Background: Due to low energy levels in microphotodiode-based subretinal visual prostheses, an external power supply is mandatory. We report on the surgical feasibility and the functional outcome of the extraocular part of an approach to connect a subretinal prosthesis to an extracorporeal connector in the retro-auricular space via a trans-scleral, transchoroidal cable.

Methods: Seven volunteers with retinitis pigmentosa received an active subretinal implant; energy was supplied by gold wires on a trans-sclerally, transchoroidally implanted polyimide foil leading to the lateral orbital rim where it was fixated and connected to a silicone cable. The cable was implanted subperiostally beneath the temporal muscle using a trocar to the retro-auricular space where it penetrated the skin for connection to a stimulator. To avoid subretinal movement of the implant, three tension relief points have been introduced.

Results: All implantations were performed as planned without complications, and no serious adverse events occurred in the postoperative period. Fixation of the implants was stable throughout the entire study duration of 4 weeks; permanent skin penetration proved to be uncomplicated. Motility was minimally restricted in downgaze and ab-/adduction. Explantation was uneventful.

Conclusion: The above-described procedure provides a method for stable fixation of a subretinal device with a trans-scleral, transchoroidal cable connection to an extracorporeal connector.

Footnotes

  • Competing interests: According to the journal’s guidelines, the authors declare the following: (1) the retinal implant was manufactured and delivered by Retina Implant AG (RIAG), Gerhard-Kindler-Straße 8, D-72770 Reutlingen, Germany; (2) RIAG covered the direct costs of the study; (3) HS, EZ and FG are shareholders of RIAG; none of them receives payment or is employed by RIAG.

  • Ethics approval: The ethics committee of the Medical Faculty of the University of Tübingen provided the approval.

  • Patient consent: Obtained.

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