title: Intraorbital implantation of a stimulating electrode for an optic nerve visual prosthesis. Case report.
abstract: Research into visual prosthetics is expected to revolutionize the treatment of blind patients with incurable outer retinal degenerative disease. Substantial evidence shows that useful visual sensations can be produced by controlled electrical stimulation of the optic nerve. To make the optic nerve visual prosthesis more acceptable, implantation techniques safer and less invasive than those previously used have been developed. A medial transconjunctival approach is now used to implant a stimulating electrode around the intraorbital section of the optic nerve. This new technique allows sufficient exposure of the nerve after detaching only one rectus muscle and performing a lateral canthotomy. Previously, an electrode was implanted in the intracranial part of the optic nerve, which required more invasive surgery. The new technique was first developed in cadavers and in patients undergoing eye enucleations. Finally, a 68-year-old blind man suffering from retinitis pigmentosa underwent long-term implantation. In this case report the authors describe the technique and outline some of the challenges involved.
authors.affiliation: Neural Rehabilitation Engineering Laboratory, Université Catholique de Louvain, Brussels, Belgium.
authors.forename: Mårten E
authors.initials: ME
authors.lastname: Brelén
authors.forename: Patrick
authors.initials: P
authors.lastname: De Potter
authors.forename: Michel
authors.initials: M
authors.lastname: Gersdorff
authors.forename: Guy
authors.initials: G
authors.lastname: Cosnard
authors.forename: Claude
authors.initials: C
authors.lastname: Veraart
authors.forename: Jean
authors.initials: J
authors.lastname: Delbeke
mesh_terms: D000368:Aged; D001766:Blindness / Q000503:physiopathology / Q000628:therapy*; D002869:Chromosome Aberrations; D004599:Electric Stimulation Therapy; D004567:Electrodes, Implanted; D005074:Evoked Potentials, Visual / Q000502:physiology; D005240:Feasibility Studies; D005500:Follow-Up Studies; D005808:Genes, Recessive; D006801:Humans; D007091:Image Processing, Computer-Assisted; D021621:Imaging, Three-Dimensional; D008279:Magnetic Resonance Imaging; D008297:Male; D009900:Optic Nerve / Q000503:physiopathology*; D009915:Orbit; D020273:Orbital Implants; D011183:Postoperative Complications / Q000175:diagnosis / Q000503:physiopathology; D011474:Prosthesis Design; D017755:Prosthesis Fitting; D012174:Retinitis Pigmentosa / Q000235:genetics / Q000503:physiopathology / Q000628:therapy*; D014057:Tomography, X-Ray Computed