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Development of a surgical approach for a wide-view suprachoroidal retinal prosthesis: evaluation of implantation trauma

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Abstract

Background

Our research goal is to develop a safe, reproducible surgical approach for implantation of a wide-field retinal stimulating array. The aim of this study was to evaluate the pathological response to acute implantation of a functional prototype electrode array in the suprachoroidal space.

Methods

The surgical techniques to implant a 72 platinum electrode array fabricated on 8 × 13 × 0.4 mm polyimide and silicone substrate were developed in a pilot study in anesthetized cats. For the main study, nine eyes were implanted in vivo and unoperated eyes were used as controls. Surgery consisted of a temporal approach with a full-thickness scleral incision 5 mm posterior to the limbus. A suprachoroidal “pocket” was created, the electrode array inserted to sit beneath the area centralis, and placement was confirmed visually. The eyes were collected subsequently for histopathology.

Results

The array was consistently inserted into the suprachoroidal space beneath the area centralis in nine eyes. There was a significant hemorrhage in two cases where implantation was complicated by choroidal congestion. Retinal folding occurred only when the array tip was within 2.6 mm of the optic disc (p < 0.01). There was choroidal incarceration at the incision in six eyes and scleral distortion at the array edges in five. No cases were found where the implant breached the retina, choroid, or sclera.

Conclusions

A large stimulation array can be reliably inserted into the suprachoroidal space without trauma to the neuroretina. These findings suggest that this is an appropriate surgical approach for the placement of an electrode array for use in retinal stimulation.

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Acknowledgements

The authors wish to thank Tom Landry and David Perry for assistance with data collection, Maria Clarke for assistance with histology and eye pathology, and Rebecca Argent for assistance with imaging. This work was performed at the Bionic Ear Institute at St. Vincent’s Hospital, and the Department of Otolaryngology from the University of Melbourne at the Royal Victorian Eye and Ear Hospital. Funding was provided by the Ian Potter Foundation, the John T. Reid Charitable Trusts, and the Australian Research Council through its Special Research Initiative in Bionic Vision Science and Technology grant to Bionic Vision Australia (BVA). J. Villalobos is being supported by the University of Melbourne, Fundacion GCC and National ICT Australia. The Bionic Ear Institute acknowledges the support it receives from the Victorian Government through its Operational Infrastructure Support Program.

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Authors and Affiliations

  1. The Bionic Institute, East Melbourne, VIC, 3002, Australia

    Joel Villalobos, Meera Ulaganathan, Robert K. Shepherd & Chris E. Williams

  2. Centre for Eye Research Australia, University of Melbourne, Melbourne, VIC, 3002, Australia

    Penelope J. Allen, Mark F. McCombe & Ehud Zamir

  3. Royal Victorian Eye & Ear Hospital, East Melbourne, VIC, 3002, Australia

    Penelope J. Allen, Mark F. McCombe & Ehud Zamir

  4. Department of Electrical and Electronic Engineering, University of Melbourne, Melbourne, VIC, 3010, Australia

    Joel Villalobos

  5. National ICT Australia, Victoria Research Laboratory, Parkville, VIC, 3010, Australia

    Joel Villalobos & David C. Ng

  6. Department of Surgery, University of Melbourne, Melbourne, VIC, 3050, Australia

    Chris E. Williams

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  1. Joel Villalobos
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  2. Penelope J. Allen
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  3. Mark F. McCombe
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  4. Meera Ulaganathan
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  5. Ehud Zamir
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  6. David C. Ng
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  7. Robert K. Shepherd
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  8. Chris E. Williams
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Corresponding author

Correspondence to Chris E. Williams.

Additional information

Joel Villalobos and Penelope J. Allen contributed equally to this work.

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Villalobos, J., Allen, P.J., McCombe, M.F. et al. Development of a surgical approach for a wide-view suprachoroidal retinal prosthesis: evaluation of implantation trauma. Graefes Arch Clin Exp Ophthalmol 250, 399–407 (2012). https://doi.org/10.1007/s00417-011-1794-6

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  • DOI: https://doi.org/10.1007/s00417-011-1794-6

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