Ocular Prosthesis Research Articles

Quality of Life in Patients With Acquired Anophthalmia Using an Ocular Prosthesis.

To employ a validated survey for evaluation of quality of life (QoL) outcomes and associated factors in a US cohort of adult patients with acquired anophthalmia wearing a prosthesis. A retrospective cohort study was performed at a single, US academic institution of patients cared for between 2012 and 2021. The electronic medical record database was queried for adult patients with a history of evisceration or enucleation surgery and placement of an orbital implant. Identified patients were asked to anonymously complete a validated QoL questionnaire from which the Global Ocular Prosthesis Score was assessed. Summary statistics were reported, and analysis of variance was used to determine surgical and demographic factors associated with QoL survey scores. A total of 81 patients completed the questionnaire. Mean age was 45.8 years (range: 18-96 years), and 54.3% of patients identified as women. Enucleation was performed in 81.4% of eyes (n = 66), while the remaining 17.3% underwent evisceration (n = 14). The mean and median Global Ocular Prosthesis Score (out of 100) were 67.51 and 68.00, respectively. Multivariate analysis demonstrated the etiologies of glaucoma (95% confidence interval: 0.84-25.40, p = 0.04) and endophthalmitis (95% confidence interval: 0.41-23.72, p = 0.04) to be significantly associated with higher total Global Ocular Prosthesis Score. Several other factors including employment status, etiology of anophthalmia, gender, and level of education were also significantly associated with subdomain scores (p < 0.05). Among patients with anophthalmia wearing an ocular prosthesis, the etiology of anophthalmia was significantly associated with the Global Ocular Prosthesis Score. Employment status, etiology of anophthalmia, gender, and level of education were also observed to have statistically significant associations with subdomain scores. Knowledge of these factors moving forward may help the surgeon manage expectations, mitigate challenges, and promote higher QoL outcomes for patients with acquired anophthalmia.

Custom Ocular Prosthesis With Intraoral Obturator for Orbital and Intraoral Defects Resulting From Mucormycosis: A Technical Case Report

Custom Ocular Prosthesis With Intraoral Obturator for Orbital and Intraoral Defects Resulting From Mucormycosis: A Technical Case Report

REHABILITATION AFTER SURVIVING OCULAR ONCOLOGY. LITERATURE REVIEW

New drugs and methods of early diagnosis of malignant tumors of the visual organ have appeared in the last decades. Nevertheless, the problem of untimely diagnosis and treatment of these diseases remains in practical ophthalmology, which leads to more radical and less organ-preserving methods of treatment and, as a consequence, to the deterioration of cosmetic and functional results in subsequent eye prosthetics.Aim. To analyze and discuss the literature on the following topics: ocular prosthetics and ophthalmic oncology using available databases.Material and methods. Optimization of domestic and foreign scientific papers using eLibrary, PubMed, ScienceDirect and Google Scholar databases.Results. The 52 most relevant sources of domestic and foreign literature were analyzed.Conclusions. Having analyzed the literature data in domestic and foreign sources, we can conclude that the world medical community has not fully disclosed the issue of eye prosthetics in patients after oncological treatment. More research and practical recommendations are needed in this area. The use of a staggered prosthetic method, as well as the shape of the eye prosthesis, taking into account the individual characteristics of the conjunctival cavity, will help to achieve the best results.

Innovative hybrid approach: digital and analog fabrication of orbital prosthesis for post-COVID-19 mucormycosis defects using photogrammetry technique

In addition to anatomical loss, removal of the full or portion of the orbit results in a facial deformity and psychological distress for the patient. This article details a practical case of prosthetic rehabilitation using digital workflow for an orbital deformity caused by post-COVID-19 Mucor mycosis. The main goal of this case study was to create a maxillofacial orbital prosthesis that is well-retained, simple to use, and accurate in terms of appearance. The study addresses the problems involved in fabricating the orbital prosthesis, particularly the unique dimensions and form of the defect, replicating the natural skin tone, and accomplishing retention by the most prudent and patient-friendly approach. Through this article, a digitised algorithm, using photogrammetry technique for facial scan, is suggested for fabricating the prosthesis.

Eye Mapping: Innovative Technique for Precise Iris Positioning in Prosthetic Eye.

The aim of this technique is to institute "Augmented Reality Tool" in the field of maxillofacial prosthesis for an accurate and precise iris positioning in a prosthetic eye. A congenital defect, irreversible damage, a painful blind eye, sympathetic ophthalmia, or the requirement for histological confirmation of a suspected illness can all result in the absence or loss of an eye. In such circumstances, meticulous preoperative, surgical, and prosthetic planning using a multidisciplinary approach is imperative for successful rehabilitation. Augmented reality filter was used to provide precise mapping of facial landmarks and to aid in iris positioning. Smartphone device (S22) was used and artificial intelligence (AI)-generated Instagram application was unfurled and augmented reality (AR) filter was instituted. The filter available in the application made it possible to see and confirm the iris shell's location in three dimensions from various angles. The dimensions thus provided, aided in the correct positioning of the iris in the prosthetic eye. Iris positioning stands as one of the crucial steps in fabricating a patient-specific ocular prosthesis. In the present case report, iris positioning was done using AI has provided an excellent esthetics results and patient compliance was met with satisfaction. Accurate positioning of iris can be done using AR tool which is popular, easily accessible, less technique sensitive, and can be performed with slightest efforts in small clinical set-ups. Relating to patient, it is comfortable, economic, and trouble-free procedure. How to cite this article: Zilpilwar NR, Nimonkar SV, Chitlange P, et al. Eye Mapping: Innovative Technique for Precise Iris Positioning in Prosthetic Eye. J Contemp Dent Pract 2024;25(7):711-714.

A Novel Technique for Fabricating an Ocular Prosthesis: A Case Report

A Novel Technique for Fabricating an Ocular Prosthesis: A Case Report

Positioning Of Iris Using A Customized Graph Grid And A Spring Bow Assembly For Fabrication Of A Ocular Prosthesis: A Case Report

Positioning of iris in a custom-made ocular prosthesis is a technique sensitive proceedure, where visual assessment alone may not be accurate. The present article is an illustration of a case report highlighting a guided orientation and positioning of an iris, exacting the contralateral side of the eye, using a facebow. This technique gives an accurate registration of the position and alignment of iris disc assembly, thus giving a lifelike appearance to the prosthesis

Tear secretion is preserved while the area of meibomian glands is reduced in patients with prosthetic eyes, contributing to the symptoms of dry eye

Background/aimsIt is unclear whether a reduction in tear secretion contributes to the discomfort experienced by those with prosthetic eyes. Tear secretion has hitherto only been measured with the Schirmer test...

Superior rectus/levator complex in acquired anophthalmic socket repaired with spheric implant-a computed tomography scan and topographic study.

To determine whether the levator palpebrae superioris (LPS)/superior rectus (SR) muscle complex, can influence the position of the upper lid and fornix in acquired anophthalmic sockets. This comparative non-randomized and non-interventional study included retrospective data of 21 patients with unilateral acquired anophthalmic sockets repaired with spheric implants. High-resolution computed tomography (CT) measurements of the LPM/SR muscle complex and clinical topographic position of the upper lid, superior and inferior fornix depth in primary gaze position were evaluated. Demographic data were presented as frequency and percentage proportions and quantitative variables comparing the socket measurements with the normal contralateral orbit was statistically analyzed using non-parametric tests considering P<0.05. The anophthalmic orbits had a significantly shorter LPS length (P=0.01) and significantly thicker SR (P=0.02) than the normal orbit. Lagophthalmos was present in anophthalmic sockets but not in normal orbits (P=0.002), while levator function was normal in both (P>0.05, all comparisons). The superior fornix depth was similar in the anophthalmic socket and the contralateral normal orbit (P=0.192) as well the inferior fornix depth (P=0.351). Acquired anophthalmic sockets repaired with spheric implants have shorter LPS, thicker SR, and more lagophthalmos than normal orbits. The relationship of the LPS and SR with other orbital structures, associated with passive or active forces acting in the final position of the lids and external ocular prosthesis should be further investigated.

Rehabilitation of patient with unilateral congenital anophthalmia using custom ocular prosthesis

This case report aims to detail the fabrication and implementation of a custom ocular prosthesis for a patient with unilateral congenital anophthalmia. This study highlights the innovative approach, the procedures undertaken, and the significant outcomes achieved. A detailed assessment of the patient's anophthalmic socket was conducted. A custom impression technique was used to fabricate the prosthesis, ensuring optimal fit and aesthetic appearance. The process included impression making, customized prosthesis design, and fitting sessions.The custom ocular prosthesis achieved excellent aesthetic integration, restoring facial symmetry and enhancing the patient's appearance. Follow-up assessments showed satisfactory prosthesis retention, minimal discomfort, and positive psychosocial impacts, including improved self-esteem and social interactions.This case underscores the importance of individualized prosthetic solutions in managing congenital unilateral anophthalmia.

Custom made orbital prosthesis using digital approach: A case report

Factors that affect a person's quality of life can be influenced by aesthetics. In the case of involving orbits, it is a big problem in aesthetic factors and must be done immediately so as not to affect the quality of life of a person. A 76-year-old male patient came to the prosthodontic dental and oral hospital on a referral from an ophthalmologist to have an eye prosthesis because he wanted to improve his appearance. The patient wants to have an eye prosthesis immediately because of embarrassment. The creation of an eye prosthesis by printing with extraoral scans and orbital contour design is the treatment plan given to the patient. After that, the first visit to the orbital socket is scanned, the color of the eye is selected and the patient can go home. The contour of the orbit of the eye can be designed with 3D software and 3D printed for the working model, as well as the search for a suitable stock eye for the patient. The next visit can be done by selecting colors and trying them out. This speeds up visits, prosthetic comfort and aesthetics.

Near field communication tag to provide a unique identification aid for custom ocular prostheses

This technique describes a smartphone-enabled near field communication tag used as an identification aid for a custom ocular prosthesis for a pediatric patient. Near field communication tags are straightforward to read, can be readily connected to smartphone devices without the need for specialized equipment, store data in a variety of ways, are inexpensive, exceptionally thin, and flexible, and tolerate resin polymerization temperatures, making them suitable as an identification aid for an ocular prosthesis.

CUSTOMISED OCULAR PROSTHESIS FABRICATION - A CASE SERIES

Loss of an eye, whether due to trauma or medical necessity, can lead to significant physical and psychological distress This article delves into the profound impact of ocular prosthetics in alleviating the physical and psychological repercussions of eye loss. Acrylic resin has been identified as an optimal material for its durability, aesthetic fidelity, and biocompatibility in fabricating ocular prostheses. Beyond restoring facial symmetry and enhancing aesthetics, these prostheses significantly bolster patient self-confidence and overall quality of life. The series comprehensively examines four distinct methods for iris positioning and prosthesis characterization, crucial for imparting natural vitality to the prosthetic eye. Each case underscores the importance of personalized care in ocular prosthetics, emphasizing the advantages over standard stock prostheses.

Конъюнктивиты при использовании глазного протеза. Профилактика и выбор эффективной терапии

Purpose. To determine the causes of inflammatory processes when using ocular prostheses, to develop recommendations for prevention and treatment of inflammation and contraction of the conjunctival cavity in rehabilitation of persons using ocular prostheses. Methods. We have analyzed treatment effectiveness in 62 adult patients: 26 men and 36 women, aged 18–92 years, who applied for ocular prosthetic care in 2023. Operations preceding prosthetics were performed in different medical institutions. The period after surgery ranged from 6 months to 69 years. The time elapsed after the last prosthetics was from 2 months to 69 years. Resultsand discussion. All the patients underwent routine ophthalmic examination. Prosthetics was performed depending on the duration of prosthesis use, the condition of its surface and the correspondence between the shape of the prosthesis and the cavity: selection and adaptation of a standard ocular prosthesis (12 patients); repair of the prosthesis – grinding and polishing (14 patients); manufacturing of an individual ocular prosthesis according to the shape of the cavity, taking into account all the parameters of the paired eye (36 patients). Depending on the conjunctival cavity condition, drug therapy was prescribed. To objectify the assessment of treatment results, all the patients filled out questionnaires, where satisfaction with the comfort of wearing a prosthesis and their own appearance was recorded on a 5-point scale. Three weeks after the end of treatment, the administrator and the doctor called all the patients to clarify the need for correction of the prosthesis shape and medical treatment. Conclusions. The patient is satisfied with the prosthetics when the prosthesis looks like an eye and the patient does not feel discomfort when using the prosthesis. It is possible to achieve an optimal result if the prosthesis corresponds to the appearance of the paired eye, its shape fills and repeats the conjunctival cavity, the prosthesis has a smooth surface. The discrepancy between size and shape of the prosthesis and size and configuration of the cavity, sharp edges of the prosthesis, irregularities and roughness of its surface cause inflammation of the cavity, which is accompanied by an increase of mucous discharge and infection. Appointment of antibacterial or any other drug therapy without restoring smoothness of the prosthesis gives a temporary effect and promotes selection of resistant microorganisms. An ocular prosthesis in 1 year of use loses smoothness of its surface. With the observance of conjunctival cavity hygiene and careful attitude to the prosthesis – regular (1 time per year) repair of a plastic prosthesis, it is possible to extend the period of use of a plastic prosthesis to 4–5 years without complications and inconveniences. Key words: ocular prosthesis; conjunctivitis; anophthalmos; microphthalmos; subatrophy; preventive repair; timely prosthesis replacement.

The current alternative for ocular surface and anophthalmic socket reconstruction, cryopreserved umbilical amniotic membrane (cUAM).

This report presents the results of using cryopreserved umbilical amniotic membrane (cUAM) as an alternative mucosal graft for ocular surface reconstruction in cases of anophthalmic socket contracture (ASC), cicatricial entropion (CE), and conjunctival-scleral defects. The study included patients who underwent non-commercial implantation of cUAM grafts (prepared by corneal banking methods) for ASC, CE, conjunctival defect, and scleral melting. The main success criteria for this study were the comfortable fitting of the ocular prosthesis in ASC patients, the natural eyelid position in CE patients, and the degree of conjunctivalisation in melting patients. cUAM transplantation was performed in 2 patients who could not use a prosthetic eye due to conjunctival contracture, 2 patients with CE, and 1 patient with conjunctival defect and 1 patient with conjunctival-scleral melting. The primary outcome was achieved in 83.3% (5/6) of patients. In one patient with CE, partial healing was achieved due to the persistence of CE in the medial upper eyelid. cUAM is a viable alternative to mucosal grafting for reconstructing the bulbar and palpebral conjunctival surface, fornix, and orbit, with reduced donor morbidity and shorter surgical time. Its regenerative ability allows for tissue defect healing and improves cosmetic appearance through epithelialization within weeks.

컴퓨터 설계와 3D 프린팅을 이용한 안와부의 맞춤형 보형물 제작

A facial defect can easily lead to psychological distress and social isolation due to its distinctive characteristics. Therefore, it is important to develop and appropriately offer personalized prostheses, even though the number of recipient may be limited. Since the manufacturing method for prostheses designed for stage or screen characters doesn't fundamentally differ from those personalized for everyday wear, special makeup artists can make a contribution to society as personalized prosthesis workers. This study aimed to investigate the manufacturing process for customized orbital prostheses, which can be produced and provided by special makeup artists, utilizing a digital approach. These prostheses target to address facial defects not covered by health insurance. Unlike traditional methods, this study adopted computer design and 3D printing technologies in restoring and making the prosthesis, ensuring that the results remain consistent regardless of a worker’s skill level. A customized orbital prosthesis may be prone to breakage due to its thinness at the center, and it is mot breathable because it is made of silicone rubber. This study proposed a method to reinforce the silicone to prevent easy breakage by using a reinforcing material and to address sweating by drilling a hole in the mold. The anticipated results are expected to serve as foundational data for developing a training manual aimed at educating personalized prosthesis workers.

“Ice cream cone” design of forearm free flap for orbital exenteration reconstruction

BackgroundsReconstruction post-orbital exenteration serves the dual purpose of expediting healing, laying the groundwork for cosmetic restoration, and minimising complications such as orbitosinusal fistulae. The aim of this study was to introduce a modified "Ice cream cone" (ICC) design of the Radial Forearm Free Flap (RFFF) technique used for reconstruction of orbital exenteration cavity, along with the oncological, functional, and aesthetic outcomes. MethodsThe authors conducted a retrospective study between January 2005 and December 2020. Inclusion criteria encompassed patients treated for orbitosinusal malignancies undergoing exenteration with subsequent ICC design of RFFF reconstruction. ResultsTwenty-two patients underwent exenteration with the ICC design of RFFF. At the follow-up conclusion, 65% of patients regularly used orbital prosthesis. The average waiting time until the prosthesis was 10 months. Quality of life questionnaires yielded average RFFF POSAS scores of 23.5 (SD 13,6), cervical POSAS scores of 8 (SD 13,2), and orbital cavity rehabilitation scores of 5.9 (SD: 3,32). ConclusionsICC design of RFFF is a reliable technique. It can be proposed in cases of extended exenteration with a high risk of cerebrospinal fluid (CSF) but more generally in cases of total exenteration. This technique facilitates optimal postoperative wound healing and accommodates early radiotherapy. Importantly, the bowl-shaped aspect of the orbital socket supports effective prosthetic rehabilitation for patients opting for orbital prosthesis post-surgery.

Custom-made ocular prosthesis: enhancing the iris position of post-evisceration patient

Individuals who have impaired vision as a result of illness or injury may have their appearance improved with the use of a prosthesis eye. To construct realism, symmetry, and a glance that appears natural, it is necessary to duplicate the size and arrangement of the iris with accurate pinpoint accuracy. This is crucial for developing a realistic-looking gaze. Eye loss has a profoundly debilitating impact on the mental state of the person who has suffered it. The ultimate goal of every ocular prosthesis procedure is to facilitate the patient's reintegration into society while preserving their healthy visage and self-esteem. This article provides a clinical report on the rehabilitation of a patient whose left eye had suffered intraocular foreign body damage following evisceration. A closer fit between the prosthesis and the ocular base tissue can be achieved with custom-made acrylic resin ocular prosthesis that are sized and shaped to fit the ocular socket of the patient. This close fit results in a more uniform distribution of pressure compared to factory stock eye prosthesis and is more cost-effective than stock eye prosthesis

Eyes of empowerment: A case study on the impact of custom ocular prosthesis in restoring quality of life

Ocular prostheses serve as invaluable tools in restoring both visual symmetry and psychological well-being for individuals who have experienced ocular defects. This article presents a comprehensive overview of the fabrication and placement of custom acrylic ocular prosthesis in a 39-year-old male patient who suffered left eye loss following a traumatic accident. The patient's history underscores the profound impact of ocular trauma on self-image and quality of life, highlighting the importance of prosthetic rehabilitation. Meticulous attention was paid to every step of the fabrication process, including impression taking, color matching, and fitting, to ensure optimal aesthetic outcome and functionality. The successful placement of the prosthesis resulted in significant improvements in the patient's confidence and overall well-being. This case report emphasizes the approach required for successful ocular prosthetic rehabilitation and underscores the transformative impact of custom ocular prostheses in restoring quality of life for individuals with ocular defects.

Hollow ocular prosthesis for rhinocerebral mucormycosis: A post-COVID-19 rehabilitation

Mucormycosis is an uncommon but significant developing opportunistic fungal co-infection (COVID-19) that is frequently linked with substantial morbidities. Rhino-orbit-cerebral mucormycosis (ROCM) is the severe clinical type, appearing in debilitated individuals in association with sinus or paranasal sinus involvement because of the proclivity for contiguous spread. Prompt care of Rhino-orbit-cerebral mucormycosis focuses on therapeutic medications such as antifungals, antibiotics, and vigorous surgical debridement. Post-operative orbital defect restoration can be accomplished by utilising either surgical reconstructive procedures or a prosthesis. The design of an ocular prosthesis to rehabilitate the patient based on the underlying clinical condition, prosthetic material, and prosthetic retention. The current report discusses the rehabilitation of an exenterated orbit with a cranio-naso-orbital fistula defect and contracted eyelid by a hollow ocular prosthesis with a magnet-assisted handle. The objective was to preserve the biological health of the underlying postsurgical tissue, prosthetic design and optimal aesthetics.