We are writing to congratulate Szurman et al1 for their inspiring experimental study on the miniaturized intraocular vision aid (IOVA). They have shown the feasibility of this device in a rodent model. However, several important issues pertaining to biocompatibility of this intraocular image transmission system warrant further discussion.
Szurman and colleagues have performed cataract extraction to make room for the implantation of this microelectric device into the ciliary sulcus.1 We were wondering whether this is a prerequisite for the usual fixation of the IOVA. If this happens to be the case, then cataract extraction will be a mandatory preimplantation procedure in clinical usage. Given the fact that the major indication of the IOVA is for those with severely opacified corneas, we would like to ask Szurman and colleagues how the cataract extraction can be performed smoothly under such compromised visualization in a patient with marked anterior segment opacification. If the IOVA can instead be implanted at the anterior chamber just in front of the lens, is there enough stability to ensure that complications such as iris trauma, hyphema, and lens capsular trauma do not happen?
Liu DTL, Li C, Lee VYW, Lam DSC. Experimental Implantation and Long-term Testing of an Intraocular Vision Aid in Rabbits. Arch Ophthalmol. 2006;124(4):609-610. doi:10.1001/archopht.124.4.609-b