Additional Coverage:
- With a tiny eye implant and special glasses, some legally blind patients can read again (nbcnews.com)
Breakthrough Bionic Eye Helps Restore Vision for Macular Degeneration Patients
Bonn, Germany – A groundbreaking new study published in the New England Journal of Medicine reveals that a tiny wireless chip, surgically implanted in the eye, combined with specialized augmented reality glasses, has helped patients suffering from a leading cause of blindness to read again. This innovative system offers a glimmer of hope for individuals living with advanced dry age-related macular degeneration (AMD).
The trial, conducted with 38 European patients, all in the advanced geographic atrophy stage of dry AMD, demonstrated clinically meaningful visual improvements in a significant majority of participants. AMD is a progressive condition affecting the macula, a crucial part of the retina responsible for sharp, detailed, and color vision.
As the disease advances, these cells deteriorate, leading to central vision loss, where objects directly ahead appear blurry or obscured. An estimated 1 million Americans currently live with geographic atrophy.
The “PRIMA device” system aims to replicate natural vision. Patients wear augmented reality glasses equipped with a camera that captures their visual field.
This visual information is then transmitted as infrared light to a microchip implanted at the back of the eye. The chip converts this light into an electrical current, stimulating the remaining healthy macular cells.
This stimulation sends signals to the brain, which are then interpreted as vision. Users also carry an image processor that allows them to zoom and magnify images, which are currently displayed in black and white.
One year after implantation, 80% of the 32 patients who returned for reassessment experienced significant visual improvements. While the study reported 26 serious adverse events in 19 patients, primarily related to the surgical procedure (such as elevated eye pressure or retinal bleeding), the majority resolved within two months.
Dr. Frank Holz, the lead investigator of the trial and chair of ophthalmology at the University Hospital of Bonn, described the results as a “game changer.”
“It’s the first ever therapeutic approach that has led to an improvement in visual function in this group of patients,” Dr. Holz stated.
“Late-stage age-related macular degeneration is a dismal disease. Patients are no longer capable of reading, driving a car, watching TV or even recognizing faces.
So [these results] are a game changer in my mind.”
Sheila Irvine, a 70-year-old patient who received the PRIMA device in London, shared her experience, stating that before the implant, her life was like “having two black discs in my eyes, with the outside distorted.” A self-proclaimed “avid bookworm” before her vision loss, Ms. Irvine can now enjoy crosswords and read prescriptions.
Dr. Sunir Garg, a professor of ophthalmology at Wills Eye Hospital in Philadelphia, who was not involved in the study, hailed the results as a breakthrough. He noted that current treatments for geographic atrophy primarily focus on slowing progression, with no existing method to restore lost vision.
However, the PRIMA system does have its limitations. Dr.
Demetrios Vavvas, director of the retina service at Mass Eye and Ear in Boston, also not involved in the study, highlighted the highly skilled surgical procedure required for implantation, which carries inherent risks. He also pointed out that the device does not restore normal color vision, with patients currently seeing in black and white, and requires significant training for users.
The full impact on patients’ quality of life also needs further assessment.
Despite these limitations, Dr. Vavvas expressed optimism, viewing the current PRIMA iteration as a vital steppingstone in vision restoration. He likened it to an “early release iPhone,” acknowledging its imperfections while emphasizing its immense potential.
Technical improvements are already in the works, according to Daniel Palanker, the Stanford University ophthalmology professor who invented the PRIMA system, which is being developed by Science Corp. Upcoming versions of the chip aim to increase pixel count from 400 to 10,000, potentially enabling 20/20 visual resolution with the camera’s zoom function. Future software upgrades will also allow for the perception of grayscale natural images, including faces.
Researchers are also exploring the application of this technology to other retinal diseases causing blindness, such as Stargardt disease. Further, larger trials with control groups are anticipated to provide more comprehensive data on the device’s real-world benefits and long-term efficacy.
While not a complete cure for blindness, the study underscores the significant potential of brain-computer interfaces in addressing severe visual impairment. As the technology continues to evolve, the PRIMA system could offer a truly transformative solution for a wider range of patients.