First FDA-Approved Treatment for MacTel Performed; Dr. Wykoff Shares Experience

Neurotech Pharmaceuticals announced the first commercial manufacturing, shipment, and surgical procedure for its encapsulated cell-based gene therapy Encelto (revakinagene taroretcel-lwey). Encelto was approved in March 2025 as the first and only FDA-approved treatment for adults with idiopathic Macular Telangiectasia Type 2 (MacTel).

“This is a huge milestone for people living with MacTel. For the first time, there is an FDA-approved treatment option that could change what is possible for patients," said Richard Small, Chief Executive Officer. "We have been working toward this for years, and seeing it become a reality is incredibly exciting for the Neurotech team and most importantly, for the patients who may benefit."

The first commerical surgery was performed by Charles C. Wykoff, MD, PhD, of Retinal Consultants of Texas, Houston. Dr. Wykoff spoke to Eyewire+ about his experience. 

"This first patient is a high functioning middle-aged gentleman who's had progressive visual acuity decline with meaningful areas of retinal atrophy and outer retinal loss—ellipsoid zone loss—because of their MacTel. And I thought that they would be an ideal candidate," Dr. Wykoff said. "We put it in actually their worst eye first, and the plan was if that all goes well, that we'll implant their second eye over the next few months. The surgical procedure went well and the patient's recovering nicely at this point." 

Dr. Wykoff also talked about who would be a good candidate for the encapsulated cell-based gene therapy.

"From a patient selection perspective, I think it's important that patients with MacTel, regardless of the severity of their disease, know that there's this treatment option out there now," Dr. Wykoff said. "And then when I think specifically about the patients that I'm considering surgical intervention to place one of these devices, I'm looking really at the phase 2 and phase 3 clinical trial inclusion criteria. So in my mind, I want to see areas of ellipsoid zone loss, and then ideally in patients that are symptomatic, and really for the first group of patients I'm implanting, it's patients with progressively worsening symptoms."

For more of Dr. Wykoff's comments, including tips for the surgical procedure itself, be sure to watch this week's EyewireTV. 

MacTel, or idiopathic macular telangiectasia type 2, is a bilateral, neurodegenerative disease in adults with characteristic localized retinal degeneration that causes the gradual loss of cells in the retina, resulting in vision loss and secondary alterations of the retinal vasculature, the network of blood vessels that supplies oxygen and nutrients to the retina. The approval of the gene therapy was based on results from two phase 3 trials which demonstrated that after placement of the implant, Encelto significantly slowed the loss of macular photoreceptors in MacTel patients over 24 months.