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Argus II retinal prosthesis malrotation and repositioning with intraoperative optical coherence tomography in a posterior staphyloma

Authors Seider M, Hahn P

Received 17 September 2015

Accepted for publication 23 October 2015

Published 24 November 2015 Volume 2015:9 Pages 2213—2216


Checked for plagiarism Yes

Review by Single anonymous peer review

Peer reviewer comments 2

Editor who approved publication: Dr Scott Fraser

The supplementary video shows Argus II prosthesis repositioning.

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Michael I Seider, Paul Hahn

Duke University Eye Center, Durham, NC, USA

Introduction: The Argus II retinal prosthesis may improve visual function in patients with severe vision loss from retinitis pigmentosa. Optimal centration of the electrode array over the macula is important to achieve optimal visual results. Argus tack malrotation is a novel entity that may be encountered during placement, especially in patients with posterior staphyloma.
Methods: Retrospective case review.
Results: During tacking of the electronics array a clockwise rotation occurred resulting in malposition. We hypothesize this was secondary to undue rotation or posterior pressure applied during tack insertion in conjunction with placement over a previously unrecognized posterior staphyloma. Intraoperative optical coherence tomography, because of the cross-sectional images provided, was helpful in visualizing the distance between the electronics array and the retina, which was difficult to assess using the surgical microscope alone. Repositioning was achieved by adjusting the tack without removal. The patient experienced an improvement in vision as a result of the surgery.
Conclusion: Malrotation may occur when tacking the Argus II prosthesis, and the presence of a posterior staphyloma may increase this risk. It is important to differentiate malrotation from tack misplacement – the former may be addressed with array unrotation or partial tack withdrawal and the latter may require tack removal and reinsertion. Also, intraoperative optical coherence tomography may be helpful in characterizing electronics array position during surgery.

Keywords: Argus, retinitis pigmentosa, retinal tack

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