PT  - JOURNAL ARTICLE
AU  - D Besch
AU  - H Sachs
AU  - P Szurman
AU  - D Gülicher
AU  - R Wilke
AU  - S Reinert
AU  - E Zrenner
AU  - K U Bartz-Schmidt
AU  - F Gekeler
TI  - Extraocular surgery for implantation of an active subretinal visual prosthesis with external connections: feasibility and outcome in seven patients
AID  - 10.1136/bjo.2007.131961
DP  - 2008 Oct 01
TA  - British Journal of Ophthalmology
PG  - 1361--1368
VI  - 92
IP  - 10
4099  - http://bjo.bmj.com/content/92/10/1361.short
4100  - http://bjo.bmj.com/content/92/10/1361.full
SO  - Br J Ophthalmol2008 Oct 01; 92
AB  - 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.