Intraocular Micro-LED Epiretinal Projection for Anterior Segment Blindness: Design and Large-Animal Feasibility Study.

Abstract

Irreversible anterior segment blindness with preserved retinal integrity (e.g., dense corneal opacity) remains a major clinical challenge because effective sight-restoring options are limited. Here, we describe an intraocular micro-light-emitting diode (Micro-LED) epiretinal microdisplay intended to deliver patterned optical stimulation to intact photoreceptors by bypassing opaque anterior optics. The prototype was based on a color-capable VGA microdisplay (640 × 480 pixels) and operated at <30 mW under typical conditions. An ultra-thin flexible cable and a copper-mesh-reinforced polydimethylsiloxane (PDMS) encapsulation provided a compact, conformable intraocular package with high pixel density. We evaluated a monochromatic (green) prototype in a single beagle eye (n=1) using a transscleral implantation approach and performed 7 days of postoperative follow-up with slit-lamp examination and multimodal imaging. Patterned stimulation via the implanted display elicited flash-evoked visual evoked potentials (VEPs) with consistent within-session waveform morphology, providing preliminary neurophysiological surrogate evidence of upstream visual pathway activation under the tested conditions in this single-animal pilot. The short-term postoperative course included transient hypotony and anterior segment inflammation, and implant rotation with associated inferior retinal detachment was observed by day 7, highlighting current biomechanical limitations. Beyond anterior segment opacity, the same intraocular optical interface could be explored as a modular light-delivery platform to pair with emerging retinal therapies (e.g., optogenetics), pending chronic safety and functional validation. This pilot large-animal study therefore provides a translationally relevant testbed while delineating key engineering constraints that must be addressed next.