Extraocular surgery for implantation of an active subretinal visual prosthesis with external connections:: feasibility and outcome in seven patients
Extraocular surgery for implantation of an active subretinal visual prosthesis with external connections:: feasibility and outcome in seven patients
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DOI：
10.1136/bjo.2007.131961
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发表时间：
2008-10-01
影响因子：
4.1
通讯作者：
Gekeler, F.
中科院分区：
文献类型：
--
作者：
Besch, D.;Sachs, H.;Gekeler, F.
背景：由于基于微光电二极管的视网膜下视觉假体的低能量水平，必须使用外部电源。我们报告的手术可行性和功能结果的眼外部分的方法，以连接视网膜下假体体外连接器在耳后空间通过trans-scleral，transchoroidal cable.Methods：7名志愿者视网膜色素变性接受了积极的视网膜下植入物;能量由巩膜上的金线提供，经脉络膜植入的聚酰亚胺箔通向外侧眶缘，在此处固定并连接到硅胶电缆。使用套管针将电缆植入颞肌下骨膜下耳后间隙，在此处电缆穿透皮肤连接刺激器。为避免植入物的视网膜下移动，三个张力缓解点已被introduced.Results：所有的复位都按计划进行，没有并发症，术后没有严重的不良事件发生。在整个4周的研究期间，植入物的固定是稳定的;永久性皮肤穿透被证明是不复杂的。向下注视和外展/内收运动受到最低限度的限制。结论：上述过程提供了一种通过经巩膜、经脉络膜电缆连接到体外连接器来稳定固定视网膜下装置的方法。
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.