Implantes médicos e cirurgia

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Extraocular Surgical Approach for Sub Retinal Implant Placement in Blind Patients: Cochlear Implant Lessons

Karina Brady

In inherited retinal illnesses, photoreceptors gradually deteriorate, frequently leading to blindness without accessible medication. Recently discovered sub retinal implants can replace photoreceptor functions in certain conditions. Cochlear implants are heavily utilised in the extraocular surgery for retina implants. However, a brand-new surgical technique that allowed for the safe handling of the picture sensor array had to be created. The Retina Implant Alpha IMS was inserted into the orbit through a retro auricular incision through a sub periosteal tunnel above the zygoma using a specially made trocar. It consists of a sub retinal micro photodiode array and cable connected to a cochlear-implant-like ceramic housing. In all patients, the implant housing was secured in a bone bed within a tight sub periosteal pocket. Effectiveness and short-term patient safety were the main objectives. In the first phase of the multicentre experiment, nine patients received the sub retinal visual implant in one eye. In every instance, a pull-through technique and steady positioning of the micro photodiode array were possible without compromising the device’s functionality. There were no difficulties throughout the operation. A sub retinal device with a transcutaneous extracorporeal power source can be safely implanted extraocular using the minimally invasive suprazygomatic tunnelling technique and a sub periosteal pocket fixation of the implant housing.