INNOVATION
Initial trials involved people with true blindness, those with no perception of light at all or patients with very limited light perception, but no ability to perceive form. As this was a proof-of-concept trial, testing the system on these patients made it easier to quantify the nature of the vision the system was providing. But there was an additional benefit which appealed to the professor: the people who qualified for the trial were the subset of patients his profession can currently do the least for, meaning any progress they could make was all the more meaningful. “We soon saw that the system was proving itself as a concept,” he said. “Patients who had been totally blind could see light. The very best patients could read letters two or three centimetres high on a computer screen. That was an incredible moment for all of us – here was someone who had been completely blind, reading letters on a screen. It was a remarkable achievement.”
Positive results
The team have recently published a paper detailing the five-year outcome of the 30 patients in the first study. When it comes to the practicalities of the device – functionality, stability and safety, Professor Da Cruz believes the results are extremely positive. But the research also highlighted an issue that the team had slowly become aware of, that of ‘usefulness’. It turned out that the people with the best technical outcomes, the ones with the best ‘vision’ were not necessarily the ones who used it the most. “Functionality and usefulness are two entirely different things. People adapt their behaviour once they lose their vision. If you read braille or have your computer read your messages, reading letters on a screen is of no use in daily life. This led us to investigate this concept of usefulness much more carefully.” One patient the surgeon recalls working with was a blind receptionist. She wasn’t among those with the best outcome in terms of visual acuity, but the device was useful
visual world, which was important to her. This patient’s experience demonstrates the mismatch between acuity and usefulness.” For Professor Da Cruz the technology
Professor Da Cruz.
With this device, she could perceive the door opening and the person coming across the room. It completely transformed her working life.
for her in a very different way. If a visitor was quiet, they could come right up to the reception desk without her noticing. Eventually, feeling as though they were being ignored, they would do something to attract her attention. Although any ill feeling evaporated when they realised she was blind, the situation would leave her embarrassed. “With this device, she could perceive the door opening and the person coming across the room,” says Professor Da Cruz. “It completely transformed her working life. What was a limited visual function proved to be extremely useful. It also meant that in some small way she had re-entered the
wasn’t the attraction; it was the fact he could now tackle areas previously off limits to his field. It was also a chance to collaborate with people from very different fields, something that he saw as an exciting challenge. He said: “By their nature, these projects are truly multidisciplinary. It is a joint venture between the engineering, bio-engineering, computer science, material science, biological, medical and psychiatric departments of institutes. It has taken this wide range of disciplines, all pushing the boundaries of their fields, to make the progress we have.” As well as being multi-disciplinary, the group is also multi-regional, with project directors scouring institutions across the globe to find the best talent. Professor Da Cruz added: “The development of the artificial retina has been a real exemplar for the multidisciplinary approach. This is an example of how it is possible to get diverse specialties to successfully work together, in what is a very complex programme.”
Sharing knowledge The London Claremont Clinic, is part of the Harley Street Medical Area. SEPTEMBER 2017
Sharing this expertise around the globe, the surgeon has also just taken part in a unique teaching exchange with Middle Eastern clinicians. His work on the bionic eye formed part of the teaching programme that was designed for ophthalmologists, optometrists and other healthcare professionals with an interest in learning about cutting-edge advances in retinal therapy. Professor Da Cruz, said: “It was really exciting to be able to teach in the Middle East. Up-to-date information on new advances is not readily available in standard text books and literature, so the course offered delegates an excellent opportunity to learn about stem cell therapy and bionic eye surgery from my first-hand experiences. “This is the first of a series of seminars across each of the medical sub-specialties and it is hoped that this type of seminar will encourage a greater interaction between clinicians from the Harley Street Medical Area and the Middle East. It was an important first step and I was delighted to be part of the ongoing interaction between these two regions.” Professor Da Cruz practices at The London Claremont Clinic, which is part of the Harley Street Medical Area. Located in Marylebone in the heart of central London, it is home to over 2,000 practitioners, small clinics and full-scale hospitals, covering just about every medical specialism and related profession. Under the careful stewardship of the Howard de Walden Estate, the Harley Street Medical Area maintains a reputation for offering the very highest standards of medical care and expertise and is notable for the sheer variety and excellence of services on offer in such an attractive and accessible setting.
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