Abstract
To report surgical observations formulated during the first 120 cases of subretinal gene therapy in patients with inherited retinal degenerations (IRDs).
A two-surgeon team compiled surgical observations and formulated surgical pearls based on the consecutive cases of subretinal viral vector injection in patients enrolled in clinical trials focusing on choroideremia, achromatopsia, and RPGR-associated retinitis pigmentosa, as well as patients with RPE65-associated Leber congenital amaurosis receiving FDA-approved voretigene neparvovec-rzyl therapy.
120 subretinal surgeries were performed by a two-surgeon team. Key anatomical features pertinent to surgical management were noted and are described in this manuscript. Surgical decision making for successful subretinal administration of viral vectors and management of potential surgical challenges were formulated.
Lessons learned during subretinal gene therapy cases may be helpful to other surgeons entering clinical trials or performing post-approval gene therapy administration. Surgical pearls outlined in this manuscript may also be helpful for other targeted subretinal therapies such as cellular transplantation or retinal prosthesis implantation.
