June 13, 2002
A Saint Louis University neurosurgeon has become the first U.S. doctor to implant a potentially revolutionary electronic eye device that allows a blind patient to see. He is the only United States doctor ever to perform the procedure.
Kenneth R. Smith Jr., M.D., professor of neurosurgery at Saint Louis University School of Medicine, performed the two- to three-hour surgical procedure in Lisbon, Portugal, in April. He was one of four specialists who operated on eight blind patients who paid to receive artificial vision systems developed by the Dobelle Institute.
A report on the progress of the patients -- and news that the artificial vision system now is commercially available abroad -- was presented June 13 at the 48th annual meeting of the American Society for Artificial Internal Organs in New York.
"With this technology, there's new hope that some patients who have lost their vision through trauma can unscramble light patterns well enough to function," Smith said. "Patients who live in darkness potentially have a light at the end of the tunnel."
The artificial vision system is a more complicated version of the visor worn by Geordi La Forge, the blind chief engineer in the science fiction television show Star Trek: The Next Generation. Patients are implanted with devices that act as artificial eyes by stimulating the visual cortex of the brain.
Two patients, who had been totally blind before their surgeries in April, have already learned to use the prosthetic system well enough to slowly drive cars on private property. They could walk freely around a laboratory, avoid obstacles and look outside a window to see a tree.
"It's amazing now. It was science fiction a few years ago," said William H. Dobelle, Ph.D., chairman and chief executive officer of The Dobelle Institute, developer of the artificial vision system. Dobelle had consulted with the writers of Star Trek: Next Generation, before they created a blind character who used an artificial vision system to see.
"As our technology improves and becomes less costly, Braille will become obsolete, the long cane will become obsolete and the guide dog will become obsolete as surely as the airplane replaced the steamship," Dobelle said.
Smith has been working with the Dobelle Institute, a privately held company that creates medical devices, since 1970. Dobelle began developing an artificial vision system in 1968, and the project has picked up steam as computer technology has improved.
The artificial vision system is designed for patients who have lost their vision from an injury and are not candidates for retinal implants. The procedure costs $98,000.
Patients use special sunglasses fitted with a miniature television camera and a microcomputer and stimulator. The gear attaches by cable to a tiny fire hydrant-like device implanted in the back of the skull that connects to electrodes on the surface of the visual part of the brain.
Patients don't have "normal" vision." Instead, they see white flashes of light that resemble stars on a black background, and learn to interpret the patterns so they can gain mobility.
"By putting an array of electrodes in the brain, patients see a pattern of white spots that they could learn to interpret well enough to get some useful vision," Smith said.
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