title: Surgical Results and Microscopic Analysis of the Tissue Reaction following Implantation and Explantation of an Intraocular Implant for Epiretinal Stimulation in Minipigs.
abstract: OBJECTIVE
  For the purpose of visual rehabilitation of subjects with photoreceptor degeneration, an implantable microelectronic device for epiretinal stimulation was developed. Our study aimed to show whether implantation and explantation could be conducted safely and to investigate tissue compatibility.
  
  
  METHODS
  The device was implanted in 5 Göttinger minipigs. Four weeks later, the implant was surgical- ly removed. Histopathological examination that followed aimed at detecting inflammatory or proliferative changes. Stains used were hematoxylin and eosin, leukocyte common antigen, CD68 and glial fibrillary acidic protein. A grinding technique was used to visualize the retinal tissue in conjunction with the retinal tacks.
  
  
  RESULTS
  The implantation of the devices was successful in all cases. The explantation was complicated by intraoperative hemorrhages. Complete explantation could only be achieved after modifying the implantation strategy. Histopathology revealed a mild degree of cystic disaggregation of the retina. Immunohistochemically, an increased glial fibrillary acidic protein expression of Müller cells was found, which shows a moderate glial cell activation. Inflammatory cells were absent. Using the grinding technique, tissue adjacent to the retinal tacks showed a mild gliosis.
  
  
  CONCLUSIONS
  The viability of implantation and explantation of the implant in minipigs has been shown. The absence of immunoreactive cells or a considerable glial reaction suggest that the device may be considered safe and suitable for further implantation in humans.
authors.affiliation: Department of Ophthalmology, RWTH Aachen University, Aachen, Germany.
authors.forename: Johannes
authors.initials: J
authors.lastname: Menzel-Severing
authors.forename: Bernd
authors.initials: B
authors.lastname: Sellhaus
authors.forename: Thomas
authors.initials: T
authors.lastname: Laube
authors.forename: Claudia
authors.initials: C
authors.lastname: Brockmann
authors.forename: Norbert
authors.initials: N
authors.lastname: Bornfeld
authors.forename: Peter
authors.initials: P
authors.lastname: Walter
authors.forename: Gernot
authors.initials: G
authors.lastname: Roessler
mesh_terms: D000818:Animals; D020878:Device Removal; D004599:Electric Stimulation Therapy / Q000295:instrumentation*; D004567:Electrodes, Implanted; D063928:Ependymoglial Cells / Q000378:metabolism; D005549:Foreign-Body Reaction / Q000209:etiology / Q000378:metabolism / Q000473:pathology*; D005904:Glial Fibrillary Acidic Protein / Q000378:metabolism; D005911:Gliosis / Q000175:diagnosis; D007150:Immunohistochemistry; D013508:Ophthalmologic Surgical Procedures; D019919:Prosthesis Implantation; D012160:Retina / Q000502:physiology / Q000601:surgery*; D012164:Retinal Diseases / Q000209:etiology / Q000378:metabolism / Q000473:pathology*; D013552:Swine; D013556:Swine, Miniature; D057488:Visual Prosthesis; D057586:Vitreoretinal Surgery
chemical_list: D005904:Glial Fibrillary Acidic Protein