Authors:
Stanislao Rizzo, Pierre Olivier Barale, Pierre Olivier Barale, Sarah Ayello-Scheer, Robert G. Devenyi, Robert G. Devenyi, Marie Noelle Delyfer, Marie Noelle Delyfer, Jean-François Korobelnik, Jean-François Korobelnik, Aleksandra Rachitskaya, Alex Y (...)
Stanislao Rizzo, Pierre Olivier Barale, Pierre Olivier Barale, Sarah Ayello-Scheer, Robert G. Devenyi, Robert G. Devenyi, Marie Noelle Delyfer, Marie Noelle Delyfer, Jean-François Korobelnik, Jean-François Korobelnik, Aleksandra Rachitskaya, Alex Yuan, K. Thiran Jayasundera, David N. Zacks, James T. Handa, Sandra R. Montezuma, Dara D. Koozekanani, Paulo E. Stanga, Lyndon da Cruz, Peter Walter, Albert J. Augustin, Lisa C. Olmos de Koo, Allen C. Ho, Bernd Kirchhof, Paul Hahn, Lejla Vajzovic, Raymond Iezzi, David Gaucher, J. Fernando Arevalo, Ninel Z. Gregori, Peter Wiedemann, Emin Özmert, Jennifer I. Lim, Flavio A. Rezende, Suber S. Huang, Francesco Merlini, Uday Patel, Robert J. Greenberg, Sally Justus, Daniela Bacherini, Laura Cinelli, Mark S. Humayun
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Abstract:
The Argus II retinal prosthesis (Second Sight Medical Products, Sylmar, CA, USA) is an electronic epiretinal implant designed for use in patients with end-stage retinitis pigmentosa, as well as for other outer retinal degenerative conditions, such as choroideremia, Leber’s congenital amaurosis, Bardet-Biedl syndrome, Usher syndrome and rod–cone disease.1 This device was tested in a clinical trial of 30 subjects in the USA and in Europe to measure the rate of serious adverse events (SAEs) and to assess its effects on functional vision and vi (...)
The Argus II retinal prosthesis (Second Sight Medical Products, Sylmar, CA, USA) is an electronic epiretinal implant designed for use in patients with end-stage retinitis pigmentosa, as well as for other outer retinal degenerative conditions, such as choroideremia, Leber’s congenital amaurosis, Bardet-Biedl syndrome, Usher syndrome and rod–cone disease.1 This device was tested in a clinical trial of 30 subjects in the USA and in Europe to measure the rate of serious adverse events (SAEs) and to assess its effects on functional vision and visual acuity.2–4 Subjects performed better on visual tasks with the device turned on and retained these improvements at 5 years postsurgery.4 Additionally, an acceptable safety profile enabled approval of the device for consumer use by the European regulatory authorities in 2011 (Conformite Europeenne (CE) mark) and by the US Food and Drug Administration (FDA) in 2013 (FDA approval). The implant is composed of an extraocular component, namely, an electronics case and implant coil, as well as an intraocular component involving a 60-electrode array that is tacked over the macula (figure 1). The extraocular and intraocular components are connected by a trans-scleral silicone-coated polyamide electrode cable, and the implantation procedure involves a 5.2 mm pars plana sclerotomy incision to insert the electrode array and the electrode cable into the eye. The sclerotomy is then sutured around the cable and covered by an allograft or autograft material.5 Figure 1 The Argus II retinal prosthesis. Labelled image of the Argus II implant (adapted from Humayun et al 2). As with any system having both intraocular and extraocular components, the trans-scleral electrode cable that traverses the sclerotomy permanently is a high-risk feature of the device, as leakage through the pars plana incision can result in chronic hypotony. The percentages of clinical trial subjects who experienced hypotony were 10.0% at …
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