The following is an edited movie of a previously live-streamed surgical video featuring renowned Consultant Ophthalmologist and Vitreoretinal surgeon Professor Paulo E. Stanga, MD, implanting the Argus® II Retinal Prosthesis System in a patient with dry Age Related Macular Degeneration (AMD). To date, June 2016, over 180 Argus® II devices have been implanted worldwide, and are used routinely in advanced Retinitis Pigmentosa patients. This video, recorded at Manchester Royal Eye Hospital, UK, in April 2016, shows Prof. Stanga performing the procedure on a dry AMD patient as part of an investigational study of the Argus® II system in dry AMD (clinicaltrials.gov #NCT02227498, being conducted under an approval from MHRA and the Ethics Committee at Manchester Royal Eye Hospital). The trial patients are the first in history to combine artificial vision provided by the Argus® II with their remaining natural peripheral sight. The surgery is commentated by Dr. Suber Huang, of University Hospitals Case Medical Center, Cleveland, Ohio and Francesco Merlini of Second Sight Medical Products Inc.
Endoscopy Assisted Argus II Epiretinal Prosthesis Implantation Surgical Video Recording done by Prof. Emin Ozmert, in Ankara University Vehbi Koç Eye Hospital, Ankara - TURKEY. By using endoscopic imaging during Argus II Retinal Implant surgery, it's easier to see that the ciliar body isn't damaged due to scleratomy as well as the retinal tack is in place and the spring is squeezed properly.
The retinal fold crossed the macula and was a residuum of retinal detachment surgery with vitrectomy and gas tamponade. The video shows the flattening of the fold across the macula via vitrectomy approach, submacular fluid injection and retinal massage from a manipulator.
PVR retinal detachment followed the implantation of a Boston keratoprothesis. The video shows PVR-vitrectomy viewing the back of the eye through the keratoprothesis. The central retina can be seen without problem. The peripheral retina cannot be seen ideally, even with indentation. The alterative is to pull the peripheral retina centrally for retinotomy with the help of a forceps. Basically all necessary steps in PVR surgery can be fullfilled through a Boston keratoprothesis.
Vitrectomy with BSS infusion in massive intraokular hemorrhage is very tiring, because of the impedment of sight from the swirling-up blood. Here a silicone oil of very low viscosity - like 20 cSt - replaces the BSS infusion, does not mix with blood and allows a rapid removal of the blood from within the eye.
vitreous hemorrhage in a newborn is a challange: Why hemorrhage: ROP? Malformation? Trauma during delivery? Iatrogenic damage to the lens and peripheral retina is at risk. Here the indication was: no pupullary red reflex, while the other eye was normal and the risk was amblyopia. The removal of the vitreous with trocar access went normal. However the infusion line slipped from the clip. The tip of the trocar leaned against the lens equator. Fortunately the caspule remained intact and the line could be secured. A sub-ILM hemorrhage was sliced and clotted blood could be aspirated from surface of the macula. The lens stayed clear. The procedure could be completed as planned.
About six months after implantation the footplate of the epiretinal implant rotated due to twist in the cable. This lead to a loss of contact with the retina. The pin holding the footplate needed to be removed. Finally also the sclerotomy needed to be reopened to abolish the twist in the cable. Unfortunately I pushed the pin through the footplate two times requiring removal of the pin and the spring separately from within the eye.
A accidental puncture for cataract surgery anesthesia caused a dense vitrous hemorrhage, the hyaloid of this 40y old male was very dificult to remove. We performed a viscodissection of the hyaloyd using a Flynn´s cannula