Abstract
BACKGROUND AND OBJECTIVE:
Optimal placement of the Argus II Retinal Prosthesis System (Second Sight Medical Products, Sylmar, CA) is critical. Intraoperative optical coherence tomography (OCT) allows for intrasurgical visualization and confirmation of array placement. In this study, two different OCT systems were evaluated to assess the feasibility and utility of this technology during Argus II surgery.
PATIENTS AND METHODS:
Intraoperative OCT was performed on five patients undergoing Argus II implantation at Cole Eye Institute from June 2015 to July 2016. The EnVisu portable OCT (Bioptigen, Morrisville, NC) and microscope-integrated RESCAN 700 (Zeiss, Oberkochen, Germany) intraoperative OCT systems were utilized. The EnVisu was used in three patients and the RESCAN 700 in three of the five patients. Following array tacking, intraoperative OCT was performed over the entire array including the edges and tack.
RESULTS:
Intraoperative OCT allowed for visualization of the array/retina interface. Microscope integration of the OCT system facilitated ease of focusing, real-time feedback, surgeon-directed OCT scanning to the areas of interest, and enhanced image quality at points of interest.
CONCLUSIONS:
Intraoperative imaging of the Argus II electrode array is feasible and provides information about electrode array-retina interface and distance to help guide a surgeon. Microscope integration of OCT appears to provide an optimal and efficient approach to intraoperative OCT during Argus II array placement.
[Ophthalmic Surg Lasers Imaging Retina. 2016;47:999–1003.]
- 1.Weiland JD, Cho AK, Humayun MS. Retinal prostheses: current clinical results and future needs. Ophthalmology. 2011; 118(11):2227–2237.
10.1016/j.ophtha.2011.08.042 Crossref Medline, Google Scholar - 2.Ahuja AK, Yeoh J, Dorn JD, Factors affecting perceptual threshold in Argus II retinal prosthesis subjects. Transl Vis Sci Technol. 2013; 2(4):1.
10.1167/tvst.2.4.1 Crossref Medline, Google Scholar - 3.Ghodasra DH, Chen A, Arevalo JF, Worldwide Argus II implantation: recommendations to optimize patient outcomes. BMC Ophthalmol. 2016; 16(1):1. Medline, Google Scholar
- 4.Ehlers JP, Goshe J, Dupps WJ, Determination of feasibility and utility of microscope-integrated optical coherence tomography during ophthalmic surgery: the DISCOVER Study RESCAN results. JAMA Ophthalmol. 2015; 133(10):1124–1132.
10.1001/jamaophthalmol.2015.2376 Crossref Medline, Google Scholar - 5.Seider MI, Hahn P. Argus II retinal prosthesis malrotation and repositioning with intraoperative optical coherence tomography in a posterior staphyloma. Clin Ophthalmol. 2015; 9:2213–2216.
10.2147/OPTH.S96570 Crossref Medline, Google Scholar - 6.Colodetti L, Weiland JD, Colodetti S, Pathology of damaging electrical stimulation in the retina. Exp Eye Res. 2007; 85(1):23–33.
10.1016/j.exer.2007.02.014 Crossref Medline, Google Scholar - 7.Yue L, Falabella P, Christopher P, Ten-year follow-up of a blind patient chronically implanted with epiretinal prosthesis Argus I. Ophthalmology. 2015; 122(12):2545–2552.
10.1016/j.ophtha.2015.08.008 Crossref Medline, Google Scholar
