Abstract
In vitro experiments and animal studies first established the biocompatibility of retinal prostheses for the treatment of retinal degenerations such as retinitis pigmentosa. Early human studies further confirmed the feasibility of implantation. The clinical trial of the most studied retinal implant, the Argus II Retinal Prosthesis, has shown good long-term safety and reliability. The clinical outcomes of the Argus II clinical trial are reviewed. The most common complications arising from retinal prosthesis implantation are discussed. These include conjunctival erosion or dehiscence, hypotony, endophthalmitis, and retinal tear or detachment. Nonserious adverse events include macular thickening, epiretinal membranes, elevated intraocular pressure, and uveitis. For each complication, the signs and symptoms of presentation are reviewed. Critical components of the ocular examination to facilitate early diagnosis are identified. The risk of potential complications may be reduced with certain preoperative and intraoperative strategies. Strategies for management of complications associated with retinal implantation are reviewed. Retinal prosthesis implantation has the potential to improve the lives of patients with retinal degenerations. Outcomes from initial clinical trials have been promising but have also identified potential complications unique to the process of retinal implantation. Early diagnosis and appropriate management of complications can preserve the full potential of retinal prostheses.
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Acknowledgments
The authors would like to thank Dr. Janet L. Davis and Dr. Ninel Z. Gregori for providing the fundus photographs of their patients with retinal detachment (Fig. 5.6) and epiretinal membrane (Fig. 5.7) at the Bascom Palmer Eye Institute, Miami, FL. The authors would also like to thank Dr. Lyndon daCruz for providing anterior segment and fundus photographs of his patient with endophthalmitis (Figs. 5.4 and 5.5) at the Moorfields Eye Hospital, London, UK.
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Devon H. Ghodasra, David N. Zacks, and K. Thiran Jayasundera declare that they have no conflict of interest. Allen C. Ho is a past consultant for Second Sight Medical Products, Inc. No human or animal studies were carried out by the authors for this chapter.
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Ghodasra, D.H., Ho, A.C., Thiran Jayasundera, K., Zacks, D.N. (2018). Retinal Prostheses: Clinical Outcomes and Potential Complications. In: Humayun, M., Olmos de Koo, L. (eds) Retinal Prosthesis. Essentials in Ophthalmology. Springer, Cham. https://doi.org/10.1007/978-3-319-67260-1_5
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