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Title: Development of a surgical procedure for implantation of a prototype suprachoroidal retinal prosthesis
Authors: Saunders, Alexia
Williams, Chris
Heriot, Wilson
Briggs, Robert
Yeoh, Jonathan
Nayagam, David
McCombe, Mark
Villalobos, Joel
Burns, Owen
Luu, Chi
Ayton, Lauren
McPhedran, Michelle
Opie, Nicholas
McGowan, Ceara
Shepherd, Robert
Guymer, Robyn
Allen, Penelope
Keywords: blindness
retinal prosthesis
retinitis pigmentosa
Issue Date: Sep-2014
Publisher: John Wiley & Sons Inc
Citation: Saunders, A. L., C. E. Williams, W. Heriot, R. Briggs, J. Yeoh, D. A. Nayagam, M. McCombe, J. Villalobos, O. Burns, C. D. Luu, L. N. Ayton, M. McPhedran, N. L. Opie, C. McGowan, R. K. Shepherd, R. Guymer and P. J. Allen (2014). Development of a surgical procedure for implantation of a prototype suprachoroidal retinal prosthesis. Clinical & Experimental Ophthalmology 42(7): 665-674.
Abstract: BACKGROUND: Current surgical techniques for retinal prosthetic implantation require long and complicated surgery, which can increase the risk of complications and adverse outcomes. METHOD: The suprachoroidal position is known to be an easier location to access surgically, and so this study aimed to develop a surgical procedure for implanting a prototype suprachoroidal retinal prosthesis. The array implantation procedure was developed in 14 enucleated eyes. A full-thickness scleral incision was made parallel to the intermuscular septum and superotemporal to the lateral rectus muscle. A pocket was created in the suprachoroidal space, and the moulded electrode array was inserted. The scleral incision was closed and scleral anchor point sutured. In 9 of the 14 eyes examined, the device insertion was obstructed by the posterior ciliary neurovascular bundle. Subsequently, the position of this neurovascular bundle in 10 eyes was characterized. Implantation and lead routing procedure was then developed in six human cadavers. The array was tunnelled forward from behind the pinna to the orbit. Next, a lateral canthotomy was made. Lead fixation was established by creating an orbitotomy drilled in the frontal process of the zygomatic bone. The lateral rectus muscle was detached, and implantation was carried out. Finally, pinna to lateral canthus measurements were taken on 61 patients in order to determine optimal lead length. RESULTS: These results identified potential anatomical obstructions and informed the anatomical fitting of the suprachoroidal retinal prosthesis. CONCLUSION: As a result of this work, a straightforward surgical approach for accurate anatomical suprachoroidal array and lead placement was developed for clinical application.
URI: http://repository.bionicsinstitute.org:8080/handle/123456789/132
Appears in Collections:Bionic Vision Research Publications

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