First Author: A.Insausti-García SPAIN
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Describe a device and an experimental surgical technique for repeated application of therapies in the subretinal and suprachoroidal spaces.
Hospital San Rafael (Madrid) – Hospital Nuestra Señora de América (Madrid) - Hospital Tres Culturas (Toledo). Spain
Experimental study in 25 ex vivo pig eyes. 13 eyes intended for suprachoroidal implantation and 12 for subretinal implantation. Procedure: Subconjunctival device implantation in temporal - superior sector. Radial sclerotomy 4 mm. Viscodissection of the subretinal or suprachoroidal space. Lighted fiber optic to dissect and guide the microcatheter. Microcatheter implantation. Prototype device manufactured on request - not commercialized. Rigid Base: Combination of methacrylate - cellulose. Diameter: 5 millimeters. Microcatheter: polyimide. External diameter 127 μ - (36 Gauge) Patent Study in Spain: Order # 72612 (P5978) 11/29/2013
Procedure performed successfully in 18 (72 %) out of 25 operated eyes. 10 of 13 (77%) in the suprachoroidal implantation group and 8 of 12 (67%) in the group of subretinal implantation. Major complications: difficulty to localize and guide the lighted optic fiber in groups, 2 choroidal perforations in the group of suprachoroidal implantation, 2 retinal perforations and 2 retinal detachments in the group of subretinal implantation.
Feasible device and reproducible surgical technique may allow repeated application of intraocular therapies in subretinal and suprachoroidal spaces. These preliminary findings should be confirmed in large in vivo studies. Controlled clinical trials, biocompatibility and cost-effectiveness studies are required.