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[Subretinal transplantation of confluent pigment epithelium: a novel device for non-traumatic tissue handling].

BACKGROUND
Subretinal transplantation of pigment epithelium may be a therapeutic option in the treatment of age-related macular degeneration. Suspensions of pigment epithelial cells as well as confluent cell layers are being considered.


METHODS
We developed a surgical device which permits to load living tissue, without exerting mechanical stress to the cells themselves, and to deliver it precisely onto the subretinal target site.


RESULTS
After having been grown to confluency on extracellular matrix, the tissue can be fixed on a cannulated spoon by creating a vacuum on its undersurface. The spoon is connected to a silicone tube attached to a syringe. The syringe is used to produce a vacuum which is delivered to the tissue through the perforated surface of the spoon. After directing the spoon into the subretinal space, the tissue can be discharged by releasing the vacuum.


CONCLUSIONS
In previous studies large cannulas have been used for injecting coherent cell layers underneath the retina. This technique frequently resulted in major distortion of the tissue. Furthermore, correct apico-basal orientation of the tissue often could not be achieved. We present a novel concept of a device which exerts vacuum to the entire underside of the graft allowing to hold it in position without distorting it. By releasing the vacuum, the graft can be positioned in the site of RPE atrophy. (Patent Reg. No. 29819018.4, München, Germany, 1998).