Article
Explantations and re-implantations in patients with active subretinal implants
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Authors
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Florian Gekeler
- Department of Ophthalmology, Katharinenhospital, Stuttgart, Germany; Center for Ophthalmology, University of Tübingen, Tübingen, Germany
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K. Stingl
- Center for Ophthalmology, University of Tübingen, Tübingen, Germany
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R. MacLaren
- Oxford University, Oxford, UK
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H. Sachs
- Städtisches Klinikum Dresden, Dresden, Germany
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E. Zrenner
- Center for Ophthalmology, University of Tübingen, Tübingen, Germany
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K.U. Bartz-Schmidt
- Center for Ophthalmology, University of Tübingen, Tübingen, Germany
| Published: | November 30, 2017 |
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Outline
Text
Objective: Explantations and re-implantations of retinal implants can become indicated for many reasons, among them device failures and the patient’s wish for newer, improved implants. We have performed explantations and re-implantations in patients with retinitis pigmentosa who had received a subretinal implant.
Materials and Methods: Sixty-one patients have been operated with a subretinal implant (Alpha-IMS n=41, Alpha-AMS n=20, Retina Implant AG, Reutlingen, Germany), 36 explantations and 3 re-implantations have been conducted; 2 re-implantations were immediately performed after the explantation, 1 re-implantation 8 years later. In addition, 1 patient received a place holder in the subretinal space for a future implantation.
Results: Explantations were uncomplicated as the silicone oil endotamponade routinely instilled during implantation can be left and the implant can be pulled out after minor re-opening of scleral and choroidal tissue. Patients who received immediate re-implantation had their silicone oil removed for the re-implantation. In these cases, re-implantation was uneventful and function improved as expected. In the patient who was re-implanted 8 years after explantation the desired optimal position under the fovea was not reachable as in the first surgery due to adhesions in the region of the previous chip’s position. This resulted in a slightly off-center position and resulted in decreased functional results compared to the first surgery.
Discussion: Explantations are feasible and unproblematic. Re-implantations are feasible in our cases but immediate re-implantation or insertion of a place holder foil for later implantation seem recommended.
