Objective:

To present the surgical technique for subretinal placement of the PRIMA implant, an investigational therapy for advanced geographic atrophy.

Approach:

• Surgical Technique Overview: The PRIMA subretinal implant is designed for vision restoration in geographic atrophy (GA) by creating a subretinal bleb and inserting a photovoltaic implant that converts light into electrical signals.
• Surgical Procedure: The procedure involves vitrectomy, creating a retinotomy, and inserting the implant using a Flex Loop or soft-tip cannula, with careful management of the subretinal bleb.

Key Findings:

• The pivotal trial PRIMAvera showed significant vision improvement in patients with GA, as reported by Dr. Brodie.
• 80% of patients who were 20/400 or worse were able to read letters and numbers post-implantation, according to trial results.
• The implant consists of 378 individual photo cells and is designed to work with infrared goggles.

Interpretation:

Dr. Brodie suggested that the technology may have broader applications for other retinal atrophies, such as Stargardt disease and potentially retinitis pigmentosa.

Limitations:

• The study had instances of macular holes, indicating the need for careful preoperative planning, as noted in the trial.
• The technology requires intact inner retina anatomy for effective use, based on study findings.

Conclusion:

The PRIMA implant represents a novel approach to restoring vision in patients with geographic atrophy, as indicated by the PRIMA trial results, and may be applicable to other retinal diseases.