3 The procedure

3 The procedure

3.1 Retinitis pigmentosa causes loss of retinal photoreceptors but inner retinal cells (ganglion and bipolar cells) remain intact. Insertion of an epiretinal prosthesis aims to restore perception of light, movement and shapes by surgically implanting an array of electrodes onto the retina. The electrodes emit electrical impulses to stimulate the sensory neurons of surviving retinal cells, which send visual information to the brain.

3.2 An epiretinal prosthesis system has 2 key components: an eye implant and external camera system. The eye implant consists of an episcleral receiver unit and an epiretinal electrode array. The external camera system comprises an eyeglass‑mounted video camera and a small patient‑worn computer (video processing unit [VPU]).

3.3 Insertion of the eye implant is performed with the patient under general anaesthesia, usually in 1 procedure that may take several hours. The surgeon performs core and peripheral vitrectomies, followed by dissection of any epiretinal membrane in the area where the electrode array will be placed. The electrode array is then inserted through a temporal sclerotomy and secured onto the retina using a retinal tack. It is connected to the receiver unit by a cable that penetrates the sclera in the pars plana.

3.4 After surgery, when the implant is set up and fully functional, the video camera records real‑time images and sends them to the VPU. The VPU converts the images into data that are wirelessly transmitted to the episcleral receiver unit. The episcleral receiver unit relays the data to the electrode array, which produces electrical impulses that bypass damaged photoreceptors and stimulate the retina's remaining cells. Visual information is then transmitted by the optic nerve to the brain, creating a visual percept.

  • National Institute for Health and Care Excellence (NICE)