Abstract
Various incurable eye diseases in companion animals often result in phthisis bulbi and eye removal surgery. Currently, the evisceration method using silicone balls is useful in animals; however, it is not available to those with impaired cornea or severe ocular atrophy. Moreover, ocular implant and prostheses are not widely used because of the diversity in animal size and eye shape, and high manufacturing cost. Here, we produced low-cost and customized artificial eyes, including implant and prosthesis, using computer-aided design and three-dimensional (3D) printing technique. For 3D modeling, the size of the artificial eyes was optimized using B-mode ultrasonography. The design was exported to STL files, and then printed using polycaprolactone (PCL) for prosthesis and mixture of PCL and hydroxyapatite (HA) for ocular implant. The 3D printed artificial eyes could be produced in less than one and half hour. The prosthesis was painted using oil colors and biocompatible resin. Two types of eye removal surgery, including evisceration and enucleation, were performed using two beagle dogs, as a preliminary study. After the surgery, the dogs were clinically evaluated for 6 months and then histopathological evaluation of the implant was done. Ocular implant was biocompatible and host tissue ingrowth was induced after in vivo application. The custom-made prosthesis was cosmetically excellent. Although long-term clinical follow-up might be required, the use of 3D printed-customized artificial eyes may be beneficial for animals that need personalized artificial eye surgery.
Highlights
Various incurable eye diseases in dogs often require eye removal surgery, with poor aesthetic results of facial deformation [1,2,3]
For size of ocular prosthesis, the X-axis and Z-axis were determined by the diameter of the eyeball that passes through the transverse section of the lens and length from the cornea to the posterior lens capsule in the transverse plane of the ultrasonography, respectively (Fig 1)
For output of the orbital implant, the mixture of PCL/HA was placed into the barrel of the air dispenser before printing
Summary
Various incurable eye diseases in dogs often require eye removal surgery, with poor aesthetic results of facial deformation [1,2,3]. Many dog owners prefer surgical procedures that can preserve the eye shape, despite the lack of vision. Evisceration using intraocular silicone prosthesis (ISP) as an orbital implant has been performed frequently in dogs [4, 5]. Inserting an ISP after evisceration has cosmetically acceptable results; it has some limitations. This method cannot be used in patients with corneal problems or severe ocular atrophy [6]. 62% of the owners whose dogs underwent both
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