The Implantable Miniature Telescope for macular degeneration.
ABSTRACT The function is described of the Implantable Miniature Telescope, which is completing clinical development for bilateral end-stage macular degeneration, and 6-month results of the Phase II/III IMT002 prospective, multicenter study are presented. Multispecialty patient management and implications of the study's findings are discussed.
No medical treatments are currently available for bilateral end-stage age-related macular degeneration (atrophic or disciform scar age-related macular degeneration). The visual prosthetic device discussed in this update is implanted in the posterior chamber to reduce the impact of the scotomata on the patient's central vision. The goal of treatment is to improve the patient's ability to perform everyday activities and participate in roles and hobbies that impact their quality of life. Patients implanted with the device experienced clinically significant gains in visual acuity and quality of life at 6 months. In total, 89% gained two or more lines of best-corrected near or distance visual acuity. The device was generally safe and well tolerated. The surgical technique is important to minimize surgically related reduction in endothelial cell density.
This age-related macular degeneration visual prosthesis has been shown to improve visual acuity and quality of life for the bilateral end-stage age-related macular degeneration patient population that at present has no other acceptable options. Endothelial cell density from baseline to 6 and 12 months after device implantation was reduced due to trauma from the surgical procedure, but was compatible with a healthy cornea. Meticulous surgical technique and a comprehensive, multispecialty approach to preoperative and postoperative patient management are essential for successful outcomes.
- SourceAvailable from: Yu-Te Liao
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- "Tear fluid contains many biomarkers that closely correlate to levels found in blood, such as glucose, cholersterol, sodium, and potassium . Thus, through integrating biological sensors and telemetry, an active contact lens could provide health professionals with a new tool for research studies and for diagnosing diseases, without the need for lab chemistry or needles . Fig. 1 shows a conceptual diagram of an active contact lens. "
ABSTRACT: We present progress toward a wirelessly-powered active contact lens comprised of a transparent polymer substrate, loop antenna, power harvesting IC, and micro-LED. The fully integrated radio power harvesting and power management system was fabricated in a 0.13 μm CMOS process with a total die area of 0.2 mm<sup>2</sup>. It utilizes a small on-chip capacitor for energy storage to light up a micro-LED pixel. We have demonstrated wireless power transfer at 10 cm distance using the custom IC and on-lens antenna.IEEE Transactions on Biomedical Circuits and Systems 01/2011; DOI:10.1109/TBCAS.2010.2081989 · 3.15 Impact Factor
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ABSTRACT: To describe the surgical procedure for placement of an implantable telescope prosthesis for end-stage age-related macular degeneration. As part of a phase 2/3 clinical trial for patients with bilateral, irreversible age-related macular degeneration, the optimal procedure for monocular placement of the telescope prosthesis was determined. Because of the unique configuration of the telescope prosthesis, proper wound construction, anterior chamber management, and device insertion after phacoemulsification are critical for successful surgery. A unique surgical technique ensures appropriate placement of the telescope prosthesis, while reducing surgical trauma to the corneal endothelium.Archives of Ophthalmology 09/2007; 125(8):1118-21. DOI:10.1001/archopht.125.8.1118 · 4.49 Impact Factor
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ABSTRACT: To evaluate long-term safety and best-corrected visual acuity (BCVA) results of a telescope prosthesis in patients with end-stage age-related macular degeneration (AMD). Prospective, open-label clinical trial with fellow-eye controls. Patients with end-stage AMD (bilateral geographic atrophy or disciform scars; BCVA, 20/80 to 20/800) received the telescope prosthesis at 28 centers. Methods were similar to those described in the one-year results, with follow-up visits continuing at 18 and 24 months. Main outcome measures included BCVA change from baseline, endothelial cell density (ECD) and morphometry, and incidence of complications. At two years, data from 174 (92.6%) of 188 available patients were analyzed. Overall, 103 (59.5%) of 173 telescope-implanted eyes gained three lines or more (doubling of visual angle) of BCVA compared with 18 (10.3%) of 174 fellow control eyes (P < .0001). Mean BCVA improved 3.6 lines (standard deviation [SD], 1.9 lines) and 2.8 lines (SD, 2.3 lines) from baseline in eyes with the 3X and 2.2X device models, respectively. Mean ECD stabilized through two years, with 2.4% mean cell loss occurring from one to two years. There was no significant change in coefficient of variation or percentage of hexagonal endothelial cells from within six months to two years after surgery. The most common complication was inflammatory deposits. Long-term results of this telescope prosthesis show the substantial BCVA improvement at one year is maintained at two years. Key indicators of corneal health demonstrate ECD change that reflects remodeling of the endothelium associated with the implantation procedure. ECD stabilizes over time, and there is no evidence of any ongoing endothelial trauma.American Journal of Ophthalmology 09/2008; 146(5):664-673. DOI:10.1016/j.ajo.2008.07.003 · 4.02 Impact Factor