Prof. Paulo Edwardo Stanga

Professor Paulo Stanga conducted the world’s first bionic eye transplant in July 2015, marking the beginning of a new era for patients with sight loss.

Over its 200-year history, Manchester Royal Eye Hospital has been home to a wealth of pioneering individuals who’ve pushed the boundaries in eye care. One such individual is Professor Paulo Stanga, who carried out the world’s first implant of an artificial retina, popularly known as a ‘bionic eye’, in patients with Age-Related Macular Degeneration (AMD).

Professor Stanga is a Consultant Ophthalmologist and Vitreoretinal Surgeon at Manchester Royal Eye Hospital. He has traveled the world and held jobs in some of the busiest cities, from Buenos Aires, to New York, London, Liverpool and now Manchester. We meet him at a room in the NIHR/Wellcome Trust Manchester Clinical Research Facility surrounded by a number of specialist retinal imaging devices and looked on by a number of printed eyes displayed on posters attached to the walls. Professor Stanga became interested in pioneering research early in his career, saying that he wanted, “To challenge established concepts and develop new ways of treating patients.” Those early days were busy and demanding. He spent the early ’90s in New York working for Professor Harvey Lincoff who was one of the most famous retinal surgeons of his time. Paulo was working long hours in the week and also at weekends. He smiled as he said, “I even had to bring my wedding forward and delay my honeymoon in order to hit a deadline two days after I was married. My wife still reminds me now that we haven’t had a honeymoon.”

After New York, Paulo worked in London and Liverpool before settling in Manchester in 2003. “The opportunity was brilliant, the role gave me a chance to set up a team around my research and push on with pioneering trials.” After introducing, among others, new imaging and retinal laser technologies as well as treatment techniques into clinical care, in 2008 Paulo started setting up trials with the bionic eye. He worked closely with a US company called Second Sight who produce the Argus II Retinal Prosthesis System also known as the bionic eye. The initial trial focused on the implantation of the bionic eye for complete blindness in Retinitis Pigmentosa. He subsequently set up a pilot study of the bionic eye system in Dry AMD, one of the most common forms of severe loss of central vision, which affects 20-25 million people worldwide and 44,000 more people per year in the UK. The condition causes an impairment of the central vision resulting in people being unable to discriminate faces, read or drive. The world’s first surgery on a patient with this condition was completed by Paulo in 2015 on 80-year-old Mr Flynn, whose central vision had completely disappeared. The procedure involved attaching the implant within one of Mr Flynn’s eyes. This implant receives its visual information from a miniature camera mounted on glasses worn by the patient. The information is then transmitted wirelessly to a receiver that sits on the wall of the eye and from which the information is transferred to an array of electrodes that sits on the surface of the macula where they stimulate the remaining cells and replicate the patterns of light and darkness for the brain. The surgery was a huge success and less than two weeks later Mr Flynn was able to detect patterns of horizontal, vertical and diagonal lines on a computer screen using the newly acquired central vision provided by the implant. Paulo said, “Over time Mr Flynn is learning to interpret these patterns of light and darkness and regain some central visual function.” The implant itself cannot provide any detailed vision but it can help patients to detect distinct patterns such as door frames and shapes without having to rely solely on their peripheral vision. Paulo praised all patients who are taking part in the trial.

“We are learning because of the courage and generosity of the patients taking part in this trial. At the moment there are only five patients in this trial but their involvement now means that in time we will be able to enroll others and this way help a lot more people. We are very excited and feel very positive about this trial. Our patients are the first ever human beings to experience the combination of their natural and residual with artificial vision. This successful integration of these two types of vision will hopefully pave the way for the treatment of many other causes of blindness.” Paulo told us that he still vividly remembers when one of the first patients with Retinitis Pigmentosa to be implanted in 2009 told him that, “Over Christmas he had seen fireworks for the first time in 30 years and also the glow of the Christmas lights, he could even make out his grand kids running towards him. These are the stories that drive us.”

These unique trials are only taking place through the Manchester Vision Regeneration (MVR) Lab at the Manchester Royal Eye Hospital and NIHR/Wellcome Trust Manchester Clinical Research Facility, as well as an independent Retinal Clinical-Research Fellowship Program which Prof. Stanga set up in 2010 to contribute to this and other research. He said, “I couldn’t do any of this without the support of my team and the understanding of my family.” His fascination with the eye and his continued interest in how high end technology can help the medical industry allows Prof. Paulo Stanga to seek out solutions that haven’t been trialed or even thought of. He’s building a strong team and continues to treat patients with career defining surgery, improving the vision of many and in some cases restoring some visual function and helping patients to live more independently.