The robotic future of gene therapy surgery

[caption id="attachment_9464" align="alignright" width="1024"] Robert MacLaren[/caption] The future of gene therapy surgery will almost inevitably involve the use of robotic systems that are capable of greater precision and control than current manual techniques, Professor Robert MacLaren FRCOphth, FRCS, said at the Young Retinal Specialist (YOURS) Day. In a talk exploring current and future surgical techniques for delivering gene therapy for choroideremia and other genetic retinal diseases, Prof MacLaren said that the ongoing Robotic Retinal Dissection Device (R2D2) trial will help to develop novel surgical treatments for blindness, such as gene therapy and stem cells. The current trial will involve 12 patients in total, following on from the successful first operation in 2016 in which an epiretinal membrane was removed from the eye of a 70-year-old man with a macular hole, using the device developed by Preceyes BV. The gene therapy approach developed by Prof MacLaren’s team used a small, safe adeno-associated viral (AAV2) vector to carry the missing choroideremia gene into the light-sensing cells in the retina. To inject the virus, the patient’s retina is first detached and then the virus is injected directly into the subretinal space. While doubts have been expressed in some quarters about the long-term effectiveness of gene therapy treatment, Prof MacLaren said that the therapy has been shown to be effective up to at least four years after surgery based on a single injection of the viral vector. This provides the strongest evidence so far in humans that the effects of gene therapy are potentially permanent and could therefore provide a single treatment cure for many types of inherited blindness, including retinitis pigmentosa and age-related macular degeneration.