Bascom Palmer Eye Institute Performs First-in-Florida Surgery Following FDA Approval to Treat Rare Retinal Disease
Summary
- Macular telangiectasia type 2, or MacTel, is a rare eye disease that causes severe central vision loss.
- Bascom Palmer Eye Institute’s Dr. Thomas Albini performed the first surgery in Florida to place a microscopic implant designed specifically to treat MacTel.
- The implant’s research history dates backs more than 30 years and originated at Bascom Palmer.
Macular telangiectasia type 2, or MacTel, is a rare eye disease that causes severe central vision loss. In December 2025, a 63-year-old Florida man became the first person in the state to receive a new implant that uses gene therapy to slow the symptoms of MacTel.
Thomas Albini, M.D., and his team at Bascom Palmer Eye Institute, part of the University of Miami Miller School of Medicine, performed the surgery to place the microscopic implant, called revakinagene taroretcel-lwey or Encelto. It’s the first FDA-approved treatment designed specifically to treat MacTel.
This milestone was enabled by decades of research to develop treatments for retinal diseases. Much of this effort happened at Bascom Palmer.
About MacTel
MacTel affects about one in 10,000 people. It damages the retina in both eyes and typically leaves patients with about 20/60 vision, which causes significant problems with activities like driving or reading, said Dr. Albini, a professor of clinical ophthalmology at Bascom Palmer. The treatment is FDA-approved for use at any stage of the disease.
The patient received the implant in one eye, which allows doctors to ensure his body tolerates the implant before considering surgery for his other eye, Dr. Albini said. The implant should slow the patient’s vision loss to about half its previous rate.
Foundational Research at Bascom Palmer
MacTel was first identified in the 1980s by J. Donald Gass, M.D., a Bascom Palmer faculty member who described dozens of retinal diseases over his career.
“When this disease was first identified, an exceptional clinician was able to define it and study it in a small number of patients,” Dr. Albini said. “Even though it’s a fairly rare condition, he was able to recognize that this was a distinct entity.”
Beginning in the 1990s, Rong Wen, M.D., Ph.D., a Bascom Palmer professor of ophthalmology, studied the role of a protein called ciliary neurotrophic factor, or CNTF, in inherited retinal diseases in animals. He found that the protein promoted the survival of important retinal cells.
Scientists at Bascom Palmer and other institutions began studying ways to use the protein to treat retinal diseases in humans.
Dr. Albini has been involved in clinical trials involving CNTF for more than 15 years, studying its application in diseases including macular degeneration, retinitis pigmentosa and glaucoma. But the results were best for patients with MacTel, he said.
A Genetically Engineered Solution
The key to bringing a CNTF-based treatment to patients was genetic engineering.
“Part of the problem with the molecule was that it disappears from the eye very rapidly,” Dr. Albini explained. “If you’re going to deliver it as an injection, you would have to do an injection every single day into somebody’s eye, which isn’t practical.”
The implant uses lab-cultured human retinal pigment epithelial cells that are engineered to produce CNTF. The tiny implant contains about 300,000 of these cells, which maintains a high concentration of the protein in a patient’s eye.
The implant is different from standard gene therapy. It does not use the patient’s own cells, which reduces the potential for side effects, Dr. Albini said. If a patient no longer wants the implant, they can simply have it removed.
This surgery shows how the pathway that goes from the clinic, to the laboratory, back to the clinic isn’t straight most of the time.
Dr. Thomas Albini
The surgery is done under a microscope, and the implant is sutured into a three-millimeter incision behind the lens of a patient’s eye. The cells in the implant receive nutrients from the eye’s natural fluids, Dr. Albini said.
The implant releases the CNTF into the eye’s vitreous cavity, where it floats to the retina and the tissues beneath it. Its most beneficial effect is on Müller cells, which are next to the photoreceptors deep inside the retina.
“By virtue of keeping those cells alive, and not degenerating, it preserves the photoreceptors also,” Dr. Albini said.
Potential Applications for Glaucoma
Similar treatments could help patients with other retinal diseases. Dr. Albini’s team was involved in a recent study examining CNTF applications in glaucoma. Preliminary data showed some benefit in slowing disease progression. However, he noted, there are many other treatments for glaucoma on the market, unlike for MacTel.
Dr. Albini said the story of this implant shows the many levels of research and clinical work that go into bringing a treatment to patients. Developing a new product takes time, investment and the dedication of many people, he said. It’s often unpredictable how one discovery will contribute to treatments down the road.
When researchers and clinicians work closely at places like Bascom Palmer, they can share their findings, especially the unanticipated ones, Dr. Albini said.
“This surgery shows how the pathway that goes from the clinic, to the laboratory, back to the clinic isn’t straight most of the time,” he said.
Tags: Bascom Palmer Eye Institute, Department of Ophthalmology, Dr. Rong Wen, Dr. Thomas Albini, eye diseases, gene therapy, inherited retinal diseases, ophthalmology