title: SUBRETINAL CELL-BASED THERAPY: An Analysis of Surgical Variables to Increase Cell Survival.
abstract: OBJECTIVE
  To develop a novel surgical approach to provide consistent delivery of cell suspension into the subretinal space without cell leakage into the vitreous.
  
  
  METHODS
  Cell viability was assessed following mock injections to determine the optimal size cannula for delivery of the cells. A pars plana without vitrectomy approach was used to create a subretinal bleb with balanced salt solution using a 41-gauge cannula. GFP-labeled retinal pigment epithelium cells were injected through transretinal (n = 8) and transscleral (n = 16) injection approaches. Optical coherence tomography, fundus photography and autofluorescence, and histological analysis were used to evaluate surgical success.
  
  
  RESULTS
  The 30-gauge cannula yielded the highest recovery of cells with highest viability. The transretinal approach consistently resulted in transplanted cells in the vitreous, with some cells coming to rest on the inner limiting membrane. Conversely, the transscleral approach resulted in transplantation of cells into the subretinal space in 100% of cases. Histological analysis confirmed these results.
  
  
  CONCLUSIONS
  We have developed a novel surgical approach that resulted in encapsulation of transplanted cells into the subretinal space with a 100% success rate. This approach will provide a useful tool for further cell transplantation study and may provide an approach for clinical application of delivering cells to the subretinal space.
authors.affiliation: *Casey Eye Institute, Oregon Health & Science University, Portland, Oregon, and †Department of Neuroscience, Oregon National Primate Research Center, Oregon Health & Science University, Beaverton, Oregon.
authors.forename: David J
authors.initials: DJ
authors.lastname: Wilson
authors.forename: Martha
authors.initials: M
authors.lastname: Neuringer
authors.forename: Jonathan
authors.initials: J
authors.lastname: Stoddard
authors.forename: Lauren M
authors.initials: LM
authors.lastname: Renner
authors.forename: Steven
authors.initials: S
authors.lastname: Bailey
authors.forename: Andreas
authors.initials: A
authors.lastname: Lauer
authors.forename: Trevor J
authors.initials: TJ
authors.lastname: McGill
mesh_terms: D000818:Animals; D002470:Cell Survival; D017690:Cell Transplantation / Q000379:methods*; D004195:Disease Models, Animal; D005451:Fluorescein Angiography; D005654:Fundus Oculi; D007267:Injections; D008253:Macaca mulatta; D008268:Macular Degeneration / Q000175:diagnosis / Q000601:surgery*; D012160:Retina; D055213:Retinal Pigment Epithelium / Q000166:cytology / Q000637:transplantation*; D033581:Stem Cell Transplantation / Q000379:methods*; D041623:Tomography, Optical Coherence / Q000379:methods*; D016896:Treatment Outcome; D014821:Vitrectomy