Schimitzek H, Roessler G, Walter P
Augenklinik, RWTH Aachen.
Klin Monbl Augenheilkd. 2016 Nov;233(11):1227-1232. doi: 10.1055/s-0042-113775. Epub 2016 Sep 27.
Epiretinal visual prostheses have already been implanted in blind retinitis pigmentosa (RP) patients. Here we report on clinical experience with the Argus® II device and the EPIRET 3 device, on the basis of data from patients operated in Germany. Twenty-eight patients were implanted with the Argus II device and followed for up to three years. EPIRET 3 was implanted in six patients for a period of four weeks. With Argus II, an improvement in visual performance was achieved in the majority of cases, as demonstrated by improved localisation of a light spot and a better perception of moving targets. Mobility and self-confidence improved. The main complications were conjunctival erosion due to the combined extra- and intraocular concept of the device. Among the 28 implanted systems, two needed to be removed because complications refractive to treatment. In contrast, EPIRET 3 is a fully intraocular epiretinal system. During a four week implantation, period thresholds were recorded and exhibited high variability between subjects. However, patients were able to recognise simple patterns. Epiretinal implants for electrical stimulation of the retina should be considered to treat advanced photoreceptor degeneration, and thus to restore basic visual functions at an acceptable rate of complications.
视网膜外视觉假体已经被植入患有视网膜色素变性(RP)的盲人患者体内。在此,我们根据在德国接受手术的患者数据,报告关于阿格斯®II型设备和EPIRET 3型设备的临床经验。28名患者植入了阿格斯II型设备,并随访了长达三年时间。6名患者植入了EPIRET 3型设备,为期四周。使用阿格斯II型设备时,大多数病例的视觉性能都有改善,如光斑定位改善和对移动目标的感知增强所示。行动能力和自信心得到了提高。主要并发症是由于该设备的眼外和眼内联合设计导致的结膜糜烂。在28个植入系统中,有两个因治疗无效的并发症而需要取出。相比之下,EPIRET 3是一种完全眼内视网膜外系统。在四周的植入期间,记录了阈值,且个体间表现出高度变异性。然而,患者能够识别简单图案。应考虑使用视网膜外植入物进行视网膜电刺激,以治疗晚期光感受器变性,从而以可接受的并发症发生率恢复基本视觉功能。