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Burri C, Al-Nawaiseh S, Wakili P, Salzmann S, Krötz C, Považay B, Meier C, Frenz M, Szurman P, Schulz A, Stanzel B. Selective Large-Area Retinal Pigment Epithelial Removal by Microsecond Laser in Preparation for Cell Therapy. Transl Vis Sci Technol 2021; 10:17. [PMID: 34842907 PMCID: PMC8631056 DOI: 10.1167/tvst.10.10.17] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2021] [Accepted: 10/16/2021] [Indexed: 11/25/2022] Open
Abstract
Purpose Cell therapy is a promising treatment for retinal pigment epithelium (RPE)-associated eye diseases such as age-related macular degeneration. Herein, selective microsecond laser irradiation targeting RPE cells was used for minimally invasive, large-area RPE removal in preparation for delivery of retinal cell therapeutics. Methods Ten rabbit eyes were exposed to laser pulses 8, 12, 16, and 20 µs in duration (wavelength, 532 nm; top-hat beam profile, 223 × 223 µm²). Post-irradiation retinal changes were assessed with fluorescein angiography (FA), indocyanine green angiography (ICGA), and optical coherence tomography (OCT). RPE viability was evaluated with an angiographic probit model. Following vitrectomy, a subretinal injection of balanced salt solution was performed over a lasered (maximum 13.6 mm2) and untreated control area. Bleb retinal detachment (bRD) morphology was then evaluated by intraoperative OCT. Results Within 1 hour after irradiation, laser lesions showed FA and ICGA leakage. OCT revealed that large-area laser damage was limited to the RPE. The angiographic median effective dose irradiation thresholds (ED50) were 45 µJ (90 mJ/cm2) at 8 µs, 52 µJ (104 mJ/cm2) at 12 µs, 59 µJ (118 mJ/cm2) at 16 µs, and 71 µJ (142 mJ/cm2) at 20 µs. Subretinal injection over the lasered area resulted in a controlled, shallow bRD rise, whereas control blebs were convex in shape, with less predictable spread. Conclusions Large-area, laser-based removal of host RPE without visible photoreceptor damage is possible and facilitates surgical retinal detachment. Translational Relevance Selective microsecond laser-based, large-area RPE removal prior to retinal cell therapy may reduce iatrogenic trauma.
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Affiliation(s)
- Christian Burri
- Institute for Human Centered Engineering (HuCE)–optoLab, Bern University of Applied Sciences, Biel, Switzerland
- Biomedical Photonics Group, Institute of Applied Physics, University of Bern, Bern, Switzerland
| | - Sami Al-Nawaiseh
- Eye Clinic Sulzbach, Knappschaft Hospital Saar, Sulzbach, Saar, Germany
- Department of Ophthalmology, University of Münster, Münster, Germany
| | - Philip Wakili
- Eye Clinic Sulzbach, Knappschaft Hospital Saar, Sulzbach, Saar, Germany
| | - Simon Salzmann
- Institute for Human Centered Engineering (HuCE)–optoLab, Bern University of Applied Sciences, Biel, Switzerland
| | - Christina Krötz
- Fraunhofer Institute for Biomedical Engineering, Sulzbach, Saar, Germany
| | - Boris Považay
- Institute for Human Centered Engineering (HuCE)–optoLab, Bern University of Applied Sciences, Biel, Switzerland
| | - Christoph Meier
- Institute for Human Centered Engineering (HuCE)–optoLab, Bern University of Applied Sciences, Biel, Switzerland
| | - Martin Frenz
- Biomedical Photonics Group, Institute of Applied Physics, University of Bern, Bern, Switzerland
| | - Peter Szurman
- Eye Clinic Sulzbach, Knappschaft Hospital Saar, Sulzbach, Saar, Germany
- Klaus Heimann Eye Research Institute, Sulzbach, Saar, Germany
| | - André Schulz
- Eye Clinic Sulzbach, Knappschaft Hospital Saar, Sulzbach, Saar, Germany
- Klaus Heimann Eye Research Institute, Sulzbach, Saar, Germany
| | - Boris Stanzel
- Eye Clinic Sulzbach, Knappschaft Hospital Saar, Sulzbach, Saar, Germany
- Klaus Heimann Eye Research Institute, Sulzbach, Saar, Germany
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