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There are various techniques available for constructing a custom ocular prosthesis. The present technique report describes a digital workflow for constructing an ocular prosthesis using computed tomography integrated with digital technologies. The outer region of the healthy eyeball was segmented to produce the top surface of the prosthesis, while the contour and bottom surface were segmented from the tissue bed of the anophthalmic socket. The iris position was determined by tracing the optical nerve and confirmed by superimposing the patient's facial scan onto the soft tissue model of the computed tomography. Using these parameters, a standard tessellation language file for the ocular prosthesis was generated and 3D printed. The iris was then printed via UV technology using digital photographs of the patient's contralateral eye; characterization of the sclera and the final layer of clear acrylic resin were done conventionally. [ABSTRACT FROM AUTHOR]

The interface between material science and ophthalmic medicine is witnessing significant advances with the introduction of biopolymers in medical device fabrication. This review discusses the impact of biopolymers on the development of ophthalmic devices, such as intraocular lenses, stents, and various prosthetics. Biopolymers are emerging as superior alternatives due to their biocompatibility, mechanical robustness, and biodegradability, presenting an advance over traditional materials with respect to patient comfort and environmental considerations. We explore the spectrum of biopolymers used in ophthalmic devices and evaluate their physical properties, compatibility with biological tissues, and clinical performances. Specific applications in oculoplastic and orbital surgeries, hydrogel applications in ocular therapeutics, and polymeric drug delivery systems for a range of ophthalmic conditions were reviewed. We also anticipate future directions and identify challenges in the field, advocating for a collaborative approach between material science and ophthalmic practice to foster innovative, patient-focused treatments. This synthesis aims to reinforce the potential of biopolymers to improve ophthalmic device technology and enhance clinical outcomes. [ABSTRACT FROM AUTHOR]

Purpose: Artificial eye users (AEUs) can experience a negative impact on psychological and emotional wellbeing, including reduced social functioning, which may be a consequence of living with one eye removed, and/or of having a prosthetic eye. This may have wider consequences for their families. We aimed to explore what it means to live with a prosthetic eye, for both AEUs and their families—and how any quality of life (QoL) issues impact on their day-to-day functioning. Methods: A subset of AEUs and their family members taking part in a feasibility randomised controlled trial comparing hand-painted to digitally printed artificial eyes were invited for semi-structured interviews. Transcripts were analysed using reflexive thematic analysis. Qualitative results related to trial participation are covered elsewhere. Here, we focus on QoL and day-to-day functioning. Results: Twelve AEUs (eight males) and five spouses (one male) who had worn artificial eyes for 2–65 years took part, and four themes were identified. (1) Impact on day-to-day life: AEUs and their spouses have to adapt to (partial) sight loss, reduced levels of confidence, and social withdrawal. (2) Impact on psychological and emotional wellbeing: distress among AEUs and their spouses can be severe and prolonged, highlight unmet support needs. (3) Challenges with treatment experiences: AEUs experienced negative impact of fragmentation of care and long waiting times. (4) Worries about the future: AEUs mentioned fragility of remaining sight, and concerns around potential need for further treatment. Conclusion: Patients and their family members experience negative impact of being an AEU on their everyday lives and quality of life. There is a potential role for psychosocial support services in supporting AEUs and their families even long after eye loss. [ABSTRACT FROM AUTHOR]

Ocular prostheses play a crucial role in restoring the form, function, and esthetics of individuals who have undergone trauma or have congenital defects. This case report presents the fabrication and successful application of a ocular prosthesis for a patient who had suffered loss of eye due to trauma in his childhood days. The prosthesis provided the patient with improved facial symmetry, and psychological well-being. The fabrication process, materials used, and clinical outcomes are discussed in detail, along with a review of relevant literature on ocular prostheses.

Abstract Background This study aims to assess the influence of using 3D-printed acrylic resin versus conventional Poly-methyl methacrylate (PMMA) for fabricating ocular prostheses on the biofilm and microbial flora of anophthalmic socket. Methods A randomized controlled trial was designed as a parallel group study. Participants were allocated randomly into two groups: the control group, which received conventionally fabricated ocular prostheses (CG, n = 11), and the test group, which received digitally 3D-printed ocular prostheses (DG, n = 11). Microbiological analysis was conducted before prosthesis insertion and three months after using the ocular prosthesis. Swab samples were inoculated on blood agar, MacConkey’s agar, and Sabouraud’s dextrose agar (SDA) for isolating Gram-positive, Gram-negative, and fungal organisms, respectively. Subsequently, the plates were incubated at 37 degrees Celsius for 48 h. Additionally, a validated questionnaire was used for subjective clinical evaluation, including parameters such as comfort level, socket discharge, lacrimation, and frequency of lubrication for each ocular prosthesis patient in both groups. Results Test group (DG, n = 11) exhibited a positive, though statistically insignificant, difference (p > 0.001) in microbial growth when compared to the control group (CG, n = 11). A statistically significant difference was observed in comfort levels between the two groups, with more comfort level within group II (test group) patients. While parameters such as discharge amount, discharge location, lacrimation and lubrication frequency displayed statistically insignificant differences between the two groups, all parameters showed improved results after three months of prosthesis use. Conclusions The choice of ocular prosthesis fabrication technique did not yield a statistically significant difference in anophthalmic flora. However, the 3D-printed acrylic resin, as an artificial eye material, displayed potential advantages in reducing the colonization of opportunistic pathogens. All subjective clinical evaluation parameters exhibited enhanced outcomes after three months of prosthesis use, emphasizing the need for an adaptation period during which patients complains are alleviated. In comparison with PMMA, 3D-printed acrylic resin showcased a certain degree of anti-colonization ability against pathogenic bacteria, along with a significant level of patient comfort, suggesting its potential as a promising material for ocular prostheses. Trial registration This parallel double-blinded RCT has been registered at ClinicalTrials.gov with identification number: NCT05584865, 18/10/2022.

The recommendations for the wear and hygiene of ocular prostheses can vary among practitioners, and it is still a controversial theme in the literature. This clinical trial evaluated the microbial load, tissue health of the socket, and the participants’ opinions before and after the use of two hygiene protocols. Thirty ocular prosthesis wearers used either a Daily Protocol (DPt: hygiene once a day) or Weekly Protocol (WPt: hygiene once a week) for 5 weeks with a washout of 7 days. The microbial load was quantified by the colony-forming unit count of the aerobic bacteria, Candida spp., Staphylococcus spp., and Gram-negative bacteria. The tissue health of the socket was evaluated by scores, and patients’ opinion of the protocols was evaluated using the analogic visual scale (VAS). Data were analyzed by ANOVA Repeated Measures, Friedman, Cochran’s Q Test, Wilcoxon, Fisher, and Pearson’s chi-square tests considering p < 0.05. There was no difference in the microbial load of the microorganisms (p > 0.05). Both protocols improved socket inflammation (p = 0.005) and discharge (p < 0.001); DPt improved edema (p = 0.021) and crusting (p = 0.020). There was no difference in patients’ rating responses (VAS) for all the questions of patients’ opinion (Q1: p = 1.0; Q2: p = 1.0; Q3: p = 1.0; Q4: p = 1.0; Q5: p = 1.0; Q6: p = 0.317; Q7: p = 1.0; Q8: p = 0.159). There was a correlation between eye drops/edema (p = 0.030), eye drops/pain (p = 0.016), microbial load with discharge, inflammation, eyelid edema, and pain. Inflammation was correlated with edema at baseline (p < 0.001) and after DPt (p = 0.018), and with crusting at baseline (p = 0.003); edema was correlated with crusting at baseline (p < 0.001); crusting was correlated with discharge after WPt (p < 0.001). The protocols showed no effects on the microbial load of the anophthalmic socket and ocular prosthesis. However, better tissue health and patient acceptance were observed after both regimens.

Abstract Background Ligneous Conjunctivitis (LC) is the most common clinical manifestation of Type I Plasminogen deficiency (T1PD; OMIM# 217090), and it is characterized by the formation of pseudomembranes (due to deposition of fibrin) on the conjunctivae leading to progressive vision loss. In past times, patients with LC were treated with surgery, topical anti-inflammatory, cytostatic agents, and systemic immunosuppressive drugs with limited results (Blood 108:3021-3026, 2006, Ophthalmology 129:955-957, 2022, Surv Ophthalmol 48:369-388, 2003, Blood 131:1301-1310, 2018). The surgery can also trigger the development of membranes, as observed in patients needing ocular prosthesis (Surv Ophthalmol 48:369-388, 2003). Treatment with topical purified plasminogen is used to prevent pseudomembranes formation (Blood 108:3021-3026, 2006, Ophthalmology 129:955-957, 2022). Case presentation We present the case of a sixteen-year-old girl with LC with severe left eye involvement. We reported the clinical conditions of the patient before and after the use of topical plasminogen eye drops and described the treatment schedule allowing the surgical procedure for the pseudomembranes debulking and the subsequent use of ocular prosthesis for aesthetic rehabilitation. Conclusions The patient showed a progressive response to the topical plasminogen, with a complete absence of pseudomembrane formation at a twelve-year follow-up, despite using an ocular prosthesis.

Maxillofacial defects (extraoral or intraoral) are deformities associated with asymmetric regional body growth, unpleasing disfigurement, and a constant reminder of the traumatic experience to the individual, which mediates a more brutal impact on the tender minds of children. The primary goal in the prosthetic rehabilitation of physical defects in this case series was to maintain bodily symmetry, restore aesthetics, function to a limited extent, and psychologically uplift the patient. Reconstructive surgeries remain the mainstay of treatment modality due to better long-term results. However, some clinical scenarios make it not feasible to do so, demanding the need for prosthetic rehabilitation. To achieve the best results in growing children, complementary and cooperative work between prosthodontists and pedodontists is required. Quarterly review by the specialists ensures proper maintenance of the prosthesis and the periodic fabrication of a new prosthesis in harmony with the growing body. The following case series describes the maxillofacial rehabilitation in children with a right enucleated eye (right eye globe removed), amputated distal phalangeal part of the left index finger, and microtia right ear (malformed right external ear), highlighting the significance of minor modifications in workflow and boosting teamwork in effectively treating children. [ABSTRACT FROM AUTHOR]

Purpose: Enucleation is a common treatment modality performed for pediatric retinoblastoma patients, and the resultant defects are reconstructed using an ocular prosthesis. The prostheses are modified or replaced periodically, as the child develops due to orbital growth and patient‐error. The purpose of this report is to evaluate the replacement frequency of prostheses in the pediatric oncologic population. Methods: A retrospective review was completed by the two senior research investigators, of patients that had ocular prostheses fabricated following enucleation of their retinoblastoma from 2005 to 2019 (n = 90). Data collected from the medical records of the patient included the pathology, date of surgery, date of prosthesis delivery, and the replacement schedule of the ocular prosthesis. Results: During the 15‐year study period, 78 enucleated observations (ocular prosthesis fabricated) were included for analysis. The median age of the patients at the time of delivery of their first ocular prosthesis was calculated to be 2.6 years (range 0.3–18 years). The median time to the first modification of the prosthesis was calculated to be 6 months. The time to modification of the ocular prosthesis was further stratified by age. Conclusion: Pediatric patients require modification of their ocular prostheses throughout their growth and development period. Ocular prostheses are reliable prostheses with predictable outcomes. This data is helpful to set an expectation among the patient, parent, and provider. [ABSTRACT FROM AUTHOR]

Background: This study aims to assess the influence of using 3D-printed acrylic resin versus conventional Poly-methyl methacrylate (PMMA) for fabricating ocular prostheses on the biofilm and microbial flora of anophthalmic socket. Methods: A randomized controlled trial was designed as a parallel group study. Participants were allocated randomly into two groups: the control group, which received conventionally fabricated ocular prostheses (CG, n = 11), and the test group, which received digitally 3D-printed ocular prostheses (DG, n = 11). Microbiological analysis was conducted before prosthesis insertion and three months after using the ocular prosthesis. Swab samples were inoculated on blood agar, MacConkey's agar, and Sabouraud's dextrose agar (SDA) for isolating Gram-positive, Gram-negative, and fungal organisms, respectively. Subsequently, the plates were incubated at 37 degrees Celsius for 48 h. Additionally, a validated questionnaire was used for subjective clinical evaluation, including parameters such as comfort level, socket discharge, lacrimation, and frequency of lubrication for each ocular prosthesis patient in both groups. Results: Test group (DG, n = 11) exhibited a positive, though statistically insignificant, difference (p > 0.001) in microbial growth when compared to the control group (CG, n = 11). A statistically significant difference was observed in comfort levels between the two groups, with more comfort level within group II (test group) patients. While parameters such as discharge amount, discharge location, lacrimation and lubrication frequency displayed statistically insignificant differences between the two groups, all parameters showed improved results after three months of prosthesis use. Conclusions: The choice of ocular prosthesis fabrication technique did not yield a statistically significant difference in anophthalmic flora. However, the 3D-printed acrylic resin, as an artificial eye material, displayed potential advantages in reducing the colonization of opportunistic pathogens. All subjective clinical evaluation parameters exhibited enhanced outcomes after three months of prosthesis use, emphasizing the need for an adaptation period during which patients complains are alleviated. In comparison with PMMA, 3D-printed acrylic resin showcased a certain degree of anti-colonization ability against pathogenic bacteria, along with a significant level of patient comfort, suggesting its potential as a promising material for ocular prostheses. Trial registration: This parallel double-blinded RCT has been registered at ClinicalTrials.gov with identification number: NCT05584865, 18/10/2022. [ABSTRACT FROM AUTHOR]

The eyes, being one of the most prominent facial features, play a crucial role in facial symmetry and are subject to extensive scrutiny in terms of their morphological and functional aspects. Numerous studies have explored the association between facial symmetry and the morphology of the eyes. Symmetrical faces are generally perceived as more attractive and are believed to indicate good genetic health. As a result, research has focused on the measurements of ocular symmetry, including inter-eye distance, eye shape, and eyelid symmetry. It has been found that individuals with more symmetrical eyes are often perceived as more attractive and exhibit enhanced social desirability. The eyes play a crucial role in facial expression and are vital sensory organs. A 49-year-old patient presented with a chief complaint of facial disfigurement due to shrunken right eyelids resulting from trauma-related evisceration. Various techniques for iris positioning have been reported in the literature, but they have had limitations. This clinical report presents an improved and effective technique utilizing a customized iris positioning device, consisting of a transparent graph sheet attached to a forehead clip. The customized ocular prosthesis significantly improved the patient's quality of life and restored her self-confidence. The customized iris positioning device offered enhanced proximity to the eye and provided several advantages, including accurate pupil centralization, customization, re-verification, and being cost-effective. [ABSTRACT FROM AUTHOR]

The recommendations for the wear and hygiene of ocular prostheses can vary among practitioners, and it is still a controversial theme in the literature. This clinical trial evaluated the microbial load, tissue health of the socket, and the participants' opinions before and after the use of two hygiene protocols. Thirty ocular prosthesis wearers used either a Daily Protocol (DPt: hygiene once a day) or Weekly Protocol (WPt: hygiene once a week) for 5 weeks with a washout of 7 days. The microbial load was quantified by the colony-forming unit count of the aerobic bacteria, Candida spp., Staphylococcus spp., and Gram-negative bacteria. The tissue health of the socket was evaluated by scores, and patients' opinion of the protocols was evaluated using the analogic visual scale (VAS). Data were analyzed by ANOVA Repeated Measures, Friedman, Cochran's Q Test, Wilcoxon, Fisher, and Pearson's chi-square tests considering p < 0.05. There was no difference in the microbial load of the microorganisms (p > 0.05). Both protocols improved socket inflammation (p = 0.005) and discharge (p < 0.001); DPt improved edema (p = 0.021) and crusting (p = 0.020). There was no difference in patients' rating responses (VAS) for all the questions of patients' opinion (Q1: p = 1.0; Q2: p = 1.0; Q3: p = 1.0; Q4: p = 1.0; Q5: p = 1.0; Q6: p = 0.317; Q7: p = 1.0; Q8: p = 0.159). There was a correlation between eye drops/edema (p = 0.030), eye drops/pain (p = 0.016), microbial load with discharge, inflammation, eyelid edema, and pain. Inflammation was correlated with edema at baseline (p < 0.001) and after DPt (p = 0.018), and with crusting at baseline (p = 0.003); edema was correlated with crusting at baseline (p < 0.001); crusting was correlated with discharge after WPt (p < 0.001). The protocols showed no effects on the microbial load of the anophthalmic socket and ocular prosthesis. However, better tissue health and patient acceptance were observed after both regimens. [ABSTRACT FROM AUTHOR]

Purpose: To analyse the ocularist's perspective on the management of the anophthalmic socket and external ocular prosthesis (EOP). Methods: Ocularists from two countries were invited to participate in an online questionnaire. Data were collected on demographics, anophthalmic socket and EOP management (manufacturing, use, cleaning), complications, follow-up visits and multidisciplinary care. The frequency and proportions of the responses were statistically analysed. Results: The questionnaire was addressed to 20 Brazilian and 17 Spanish ocularists, obtaining a response rate of 65% and 64.7%, respectively. 62.5% of respondents were men. The most common cause of anophthalmia in Brazil (69.2%) and Spain (36.4%) is an eye disease (chi square: p = 0.188). Polymethylmethacrylate (PMMA) is the most commonly used material in EOP manufacture (chi square: p = 0.448), and 70.8% reported using customized EOPs (chi square: p = 0.069). Deposits are frequently observed in both countries (chi square: p = 0.157). Changing the prosthesis is recommended after 5 to 10 years by Brazilian ocularists, and after less than 5 years of use by Spanish ocularists (81.8%) (chi square: p = 0.041). Annual follow-up is recommended by Spanish ocularists (45.5%), while semestral (38.5%) and case-dependent (38.5%) follow-up is recommended by Brazilian ocularists (chi square: p = 0.267). Daily cleaning is advocated by 61.5% of Brazilian ocularists and once a month by 45.5% of Spanish ocularists (chi square: p = 0.098), with 75% of ocularists from both countries not recommending EOP removal at night (Fisher´s exact test: p = 0.166). Good communication between ocularists and ophthalmologists was reported by 87.5% of our responders (chi square: p = 0.642). Conclusion: Although there are no unified protocols on the management of EOPs, Brazilian and Spanish ocularists follow similar guidelines. Differences between countries were the patients´ referral and the prosthesis´ useful life. [ABSTRACT FROM AUTHOR]

Background: Ocular prosthesis (OP) is produced and fitted by eye care personnel called Ocularist. OP is made from cryolite glass or acrylic resin. OP can either be customized or stock and it is commonly inserted by 6-8 weeks following destructive ocular surgery. Aim: The aim of this study was to ascertain the knowledge and awareness of ocular prosthesis among students of School of Optical Dispensary Technology, Birnin Kebbi, Nigeria. Materials and methods: This was a cross-sectional study conducted over 3 months (1st April 2022-30th June 2022) among the students of School of Optical dispensary technology using self-administered questionnaires. The questionnaires extracted information on the socio-demographic characteristics such as age, sex, tribe, religion, marital status, year of study and knowledge of ocular prosthesis among the students. Data was analyzed using SPPS version 21. Results: One hundred and thirteen questionnaires were distributed to all the students in the school and 97 students participated in the study leading to a response rate of 86 %. There were 47(48.5%) males and 50 (51.5%) females aged between 16 - 40 (mean age 24±5) years. Most of the participants 72 (74.2%) agreed that eye care (management of patient with eye problem) is a team work. Most (67, 69%) participants have heard about ocular prosthesis mainly through Seminar/Teaching (32%) and television (26%). Overall, third year students had adequate knowledge (73%) of ocular prosthesis compared with second year (49%) and first year (43%) students. Conclusion: The awareness of ocular prosthesis among students of School of Optical dispensary technology Birnin Kebbi appeared better with number of years spent in the school. The importance of seminar/teaching and television in the dissemination of health information is underscored.

The ocular prosthesis is a type of maxillofacial prosthesis that restores the function of eye structure due to eye loss. Ocular prostheses are frequently available in stock fabricated form, however, customized prostheses are recommended for more aesthetic results. This case report aims to describe the treatment of an ocular prosthesis and the methods and steps to make a custom ocular prosthesis for a patient with orbital defect. A patient with an enucleation defect and a history of wearing a stock ocular prosthesis wanted to have a custom ocular prosthesis. The old prosthesis was uncomfortable, and felt insecure about her appearance. Case Management: The lightbody impression was taken in the patient's eye, creating wax-up and acrylic prosthesis. The placement of the iris and pupil was assessed to perform the normal appearance in the patient. A hollow-type acrylic was formed to avoid excessive weight on the prosthesis. The patient was delighted with the results of the treatment. Custom ocular prosthesis fabrication requires longer stages and duration compared to a stock prosthesis but will provide more satisfactory results in terms of function and aesthetics. [ABSTRACT FROM AUTHOR]

BACKGROUND: Polymerization conditions affect the physical-mechanical properties of acrylic resins used for craniofacial prostheses. OBJECTIVE: The aim of this study was to evaluate the effect of microwave polymerization on the thermomechanical properties and surface morphology of ocular prostheses fabricated with polymethyl methacrylate (PMMA). METHODS: PMMA discs were polymerized with microwave energy and with conventional heat polymerization (CHP) method. Ocular prostheses were fabricated to determine whether there were changes according to the polymerization method. The surface morphology and roughness were observed under SEM and AFM. The Vickers Hardness number (VHN) and flexural strength were measured. Thermal properties were evaluated with TGA/DSC, and chemical composition with FTIR. RESULTS: The PMMA acrylic resin polymerized with microwave energy showed a smooth surface with some relief areas. In the internal surface of the ocular prosthesis with microwave energy the PMMA is more compact. The mean roughness values were higher and statistically significant with CHP (P < 0.05), while the surface hardness and flexural strength were higher with microwave energy (P < 0.05). CONCLUSION: There were no changes in the calorimetry with either method, TGA showed an exothermic peak around 120 °C with CHP method. PMMA polymerized with microwave energy improved the mechanical and surface properties of the ocular prostheses. [ABSTRACT FROM AUTHOR]

Ocular prosthesis rehabilitation has an important social, psychological, esthetic, and functional role. Congenital factors, trauma, and tumors, among others, can cause anophthalmia, and it is essential to identify the etiology to guide its prevention and treatment. The aim of this study was to retrospectively investigate the records of patients treated from 2013 to 2020 by the Oral and Maxillofacial Prosthesis Group, aiming to identify the prevalence of patients with anophthalmia and the etiology of their anophthalmia. After approval by the Human Research Ethics Committee, two calibrated researchers evaluated 520 records, identifying those from patients with anophthalmia. The inclusion criteria were records with complete and legible information from patients with anophthalmia and a description of their etiology. Descriptive statistics were performed, and etiological factors were categorized into trauma, congenital cause, end-stage eye disease, and tumor. Spearman's correlation was performed to verify the relation between gender and anophthalmia etiology, with a 5% significance level. Seventy-two records were included in the study. It was observed that 33.4% of patients were women and 66.6% were men. The etiologies were physical trauma (52.4%), tumor (21.8%), end-stage eye disease (16.6%), and congenital cause (9.2%), and there was no correlation between gender and these etiologies (p =.301). Most of the cases identified were of traumatic origin, which allows the establishment of preventive and educational measures to avoid new cases of anophthalmia. [ABSTRACT FROM AUTHOR]

Background: Ligneous Conjunctivitis (LC) is the most common clinical manifestation of Type I Plasminogen deficiency (T1PD; OMIM# 217090), and it is characterized by the formation of pseudomembranes (due to deposition of fibrin) on the conjunctivae leading to progressive vision loss. In past times, patients with LC were treated with surgery, topical anti-inflammatory, cytostatic agents, and systemic immunosuppressive drugs with limited results (Blood 108:3021-3026, 2006, Ophthalmology 129:955-957, 2022, Surv Ophthalmol 48:369-388, 2003, Blood 131:1301-1310, 2018). The surgery can also trigger the development of membranes, as observed in patients needing ocular prosthesis (Surv Ophthalmol 48:369-388, 2003). Treatment with topical purified plasminogen is used to prevent pseudomembranes formation (Blood 108:3021-3026, 2006, Ophthalmology 129:955-957, 2022). Case presentation: We present the case of a sixteen-year-old girl with LC with severe left eye involvement. We reported the clinical conditions of the patient before and after the use of topical plasminogen eye drops and described the treatment schedule allowing the surgical procedure for the pseudomembranes debulking and the subsequent use of ocular prosthesis for aesthetic rehabilitation. Conclusions: The patient showed a progressive response to the topical plasminogen, with a complete absence of pseudomembrane formation at a twelve-year follow-up, despite using an ocular prosthesis. [ABSTRACT FROM AUTHOR]

To study the impact of the prosthesis motility on the Quality of Life (QoL) in anophthalmic patients. Cross-sectional, observational study of 100 anophthalmic patients, of whom 64% had an acryl implant, 6% an Allen implant, 1% a hydroxyapatite implant, 4% a dermis fat graft, 16% no implant, and 9% an unknown implant. We quantitatively assessed the motility of the prosthesis with Kestenbaum glasses and the QoL with a validated questionnaire covering five domains: General functional abilities and care, wearing comfort, physical appearance, psychological and social functioning. Associations between measured prosthetic eye motility, patient-perceived motility, and satisfaction were made. Motility of the prosthesis was impaired with an average loss of 76%, and correlated with Cosmetic satisfaction (adduction P =.02, abduction P =.008, elevation P =.04) and Social satisfaction (adduction P =.03, abduction P =.003). The patient-perceived motility of the prosthesis correlated with General functioning abilities (horizontal P =.0004, vertical P =.0004), Comfort (horizontal P =.001, vertical P =.003), Cosmetic satisfaction (horizontal P =.0002, vertical P =.0002), Psychological satisfaction (horizontal P =.001, vertical P =.001), and Social satisfaction (horizontal P =.002, vertical P =.003). Ocular prosthetic motility has a significant impact on patient-perceived satisfaction and physical appearance, and predicts coping with the prosthetic condition on the psychosocial level. This highlights the need of introducing patient-reported outcome measures in the prosthetic rehabilitation of the anophthalmic patient. [ABSTRACT FROM AUTHOR]

The disfigurement associated due to the loss of an eye can cause a significant physical and psychological disturbance. Psychological distress among such unfortunate patients can be reduced by providing an artificial eye. Rehabilitating such patients with an ocular defects is the most challenging task for a prosthodontist. The custom-made ocular prostheses are preferred over the prefabricated stock eye shells as it provides intimate contact with the tissue bed, enabling an ideal fit. For an esthetic ocular prosthesis, the precise positioning of an iris is a primary requirement to avoid the squint eye appearance. Various case reports are documented in the literature for centralizing the iris in the prosthetic eye. This review article explores the established methods and techniques for positioning the iris in a custom-made ocular prosthesis.

Clinical congenital anophthalmia causes facial asymmetry and difficulty in wearing ocular prostheses due to underdevelopment of the orbits. Orbital expansion must be started early after birth for treatment, but consensus regarding the treatment for clinical congenital anophthalmia has not been established. We report a successful orbital expansion using a thermoplastic splint. A one-month-old boy had left clinical congenital anophthalmia (ophthalmatrophia), right congenital glaucoma, and right anterior segment ocular dysgenesis. Two months after birth, left orbital expansion was initiated using a custom-made thermoplastic splint. The splint was replaced with larger ones in steps as the infant grew, and the orbit was successfully expanded. There is no appreciable size difference between the left and right orbit after 5 years of follow up. Treatment using a splint for the conjunctival sac is a simple and effective procedure that can be performed on an outpatient basis. Safer and simpler material should be widely used for the treatment.

Key Clinical Message: The conservative prosthodontic construction of an ocular prosthesis utilizing our novel threaded iris fabrication technique required high time and prosthodontic resource inputs and produced a lifelike aesthetic result. Patients with ocular defects frequently present with significant local anatomical deficiencies and complex histories and require extensive time and resource inputs to treat. This case report describes the conservative management of an ocular defect completed in a postgraduate prosthodontics clinical residency program utilizing a novel threaded iris fabrication technique. [ABSTRACT FROM AUTHOR]

These prostheses are generally produced using two materials, glass or acrylic, and the manufacturing process is currently based only on manual procedures. However, these materials have many disadvantages, such as high hardness and fragility of glass or gradual loss of glossing. All the main disadvantages have been eliminated in the newly developed ocular prosthesis made from silicone. The publication contains the production procedure of an innovative ocular prosthesis based on the use of additive technologies. [ABSTRACT FROM AUTHOR]

Key Clinical Message The conservative prosthodontic construction of an ocular prosthesis utilizing our novel threaded iris fabrication technique required high time and prosthodontic resource inputs and produced a lifelike aesthetic result. Abstract Patients with ocular defects frequently present with significant local anatomical deficiencies and complex histories and require extensive time and resource inputs to treat. This case report describes the conservative management of an ocular defect completed in a postgraduate prosthodontics clinical residency program utilizing a novel threaded iris fabrication technique.

Purpose: To explore the changes of bacterial flora in anophthalmic patients wearing ocular prosthesis (OP) and the microbiome diversity in conditions of different OP materials. Methods: A cross-sectional clinical study was conducted, involving 19 OP patients and 23 healthy subjects. Samples were collected from the upper, lower palpebral, caruncle, and fornix conjunctiva. 16S rRNA sequencing was applied to identify the bacterial flora in the samples. The eye comfort of each OP patient was determined by a questionnaire. In addition, demographics information of each participant was also collected. Results: The diversity and richness of ocular flora in OP patients were significantly higher than that in healthy subjects. The results of flora species analysis also indicated that in OP patients, pathogenic microorganisms such as Escherichia Shigella and Fusobacterium increased significantly, while the resident flora of Lactobacillus and Lactococcus decreased significantly. Within the self-comparison of OP patients, compared with Polymethyl Methacrylate (PMMA), prosthetic material of glass will lead to the increased colonization of opportunistic pathogens such as Alcaligenes, Dermabacter and Spirochaetes, while gender and age have no significant impact on ocular flora. Conclusions: The ocular flora of OP patients was significantly different from that of healthy people. Abundant colonization of pathogenic microorganisms may have an important potential relationship with eye discomfort and eye diseases of OP patients. PMMA, as an artificial eye material, demonstrated potential advantages in reducing the colonization of opportunistic pathogens. [ABSTRACT FROM AUTHOR]

Copyright of Die Ophthalmologie is the property of Springer Nature and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Die Ophthalmologie is the property of Springer Nature and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

The eyes, being one of the most prominent facial features, play a crucial role in facial symmetry and are subject to extensive scrutiny in terms of their morphological and functional aspects. Numerous studies have explored the association between facial symmetry and the morphology of the eyes. Symmetrical faces are generally perceived as more attractive and are believed to indicate good genetic health. As a result, research has focused on the measurements of ocular symmetry, including inter-eye distance, eye shape, and eyelid symmetry. It has been found that individuals with more symmetrical eyes are often perceived as more attractive and exhibit enhanced social desirability. The eyes play a crucial role in facial expression and are vital sensory organs. A 49-year-old patient presented with a chief complaint of facial disfigurement due to shrunken right eyelids resulting from trauma-related evisceration. Various techniques for iris positioning have been reported in the literature, but they have had limitations. This clinical report presents an improved and effective technique utilizing a customized iris positioning device, consisting of a transparent graph sheet attached to a forehead clip. The customized ocular prosthesis significantly improved the patient’s quality of life and restored her self-confidence. The customized iris positioning device offered enhanced proximity to the eye and provided several advantages, including accurate pupil centralization, customization, re-verification, and being cost-effective.

The disfigurement associated due to the loss of an eye can cause a significant physical and psychological disturbance. Psychological distress among such unfortunate patients can be reduced by providing an artificial eye. Rehabilitating such patients with an ocular defects is the most challenging task for a prosthodontist. The custom-made ocular prostheses are preferred over the prefabricated stock eye shells as it provides intimate contact with the tissue bed, enabling an ideal fit. For an esthetic ocular prosthesis, the precise positioning of an iris is a primary requirement to avoid the squint eye appearance. Various case reports are documented in the literature for centralizing the iris in the prosthetic eye. This review article explores the established methods and techniques for positioning the iris in a custom-made ocular prosthesis. [ABSTRACT FROM AUTHOR]

This case series reports on clinical challenges faced during the rehabilitation of custom ocular prosthesis. Each of these cases relate the challenges of making ocular impressions for an improved retention and support of ocular prosthesis and presents the significance of scleral contouring in overcoming cosmetic defects of the eye. In addition, evaluation of scleral wax pattern, methods of iris location and scleral characterization methods in ocular rehabilitation are further discussed.

Background: The purpose of this study is to share the experience of a modified surgical technique for treating shallow inferior fornix to enhance the retention of cosmetic ocular prosthesis in a tertiary care hospital. It was a Quasi experimental study, carried out at Khalid Eye Hospital, Karachi, Pakistan from January to December 2018. Methods: This study included twenty-five patients between the ages of 20-40 years belonging to either gender having an anophthalmic socket with shallow inferior fornices unable to retain cosmetic ocular prosthesis. Three pieces of Silicone tube were placed deep within the inferior fornix with the help of 2-0 Vicryl suture, taking bite of the inferior orbital rim periosteum. Main outcome measure was deepening of the inferior fornix with better retention of the ocular prosthesis. All the patients were followed up for a period of one year after the surgery. Study dynamics were briefed to all the patients and study approval obtained from the hospital ethical review committee. Results: This study included a total of twenty-five patients of both genders. Mean age was 29.6±6.53 years. By the end of the follow up period, twenty-four (96%) out of the twenty-five patients were satisfied with a proper retention of ocular prosthesis within the fornix along with complete lid closure. One (4%) patient required revision surgery because of extrusion of the silicone tube piece after one month. Mean follow up period was 358.5±16.76 days. Conclusion: This modified technique does not require expensive consumables and proved to be effective in terms of cosmetic and functional outcome. [ABSTRACT FROM AUTHOR]

Objectives: This study aimed to evaluate the influence of different polymerisation methods of acrylic resin for ocular prostheses on the subcutaneous tissue inflammatory response of rats. Methods: The study was conducted at the Basic Sciences Department, Araçatuba Dental School, São Paulo State University (UNESP), Brazil, from 2016 to 2018. The samples were prepared by water bath (WB), microwave energy (MW) or autopolymerisation (AP) (n = 20 samples per group). The inflammatory response (cell count and immunohistochemical analysis of interleukin [IL]-1ß, IL-6, tumour necrosis factor [TNF]-a, IL-17 and macrophage inflammatory protein-3a) was analysed by the implantation of a sample from each group in the subcutaneous tissue of 20 Wistar rats and evaluated after seven, 15, 30 and 60 days. The quantitative and qualitative data were analysed using analysis of variance and Tukey tests (P <0.05) and visual comparison, respectively. Results: There was a moderate inflammatory infiltrate for the MW and AP groups and a light infiltrate for the WB group after seven days. The inflammatory infiltrate and the immunolabeling of tested targets decreased gradually during the 60-day period. The AP group had the highest immunolabeling of TNF-a (seven days), IL-1ß and IL-17 (at 15 and 30 days) and IL-6 (at 30 and 60 days). The WB and MW groups showed greater immunolabeling at 15 and 30 days, while the MW group also had high results at 60 days. Conclusion: Polymerisation by microwave energy and by chemical activation resulted in a higher inflammatory response. [ABSTRACT FROM AUTHOR]

Purpose: To report the use of cryopreserved amniotic membrane from the umbilical cord (UC) in the reconstruction of a dehisced wound with the additional ability to increase orbital volume, expand superior and inferior fornices, and improve cosmesis following evisceration of a blind, painful, atrophic, sunken eye with ptosis. Observations: Patient developed conjunctival wound dehiscence without implant exposure following evisceration. One month later, reconstruction was performed with UC to cover the defect, increase the orbital volume, and expand orbital fornices to allow placement of a large ocular prosthesis with superior lip for ptosis elevation. Post-operatively, at the 6th week, the socket was healthy and the globe had good movement. At the 7th week, the ocular prosthesis was sized and fitted. At the 8th month, the structural integrity of the socket was maintained with deep fornices, and the patient had excellent cosmetic result with natural appearance and movement of the prosthetic eye. Conclusions and importance: This case highlights the successful utilization of UC graft to augment soft tissue volume, restore socket structural integrity and increase socket volume, and achieve good cosmesis and ocular motility following evisceration.

This case series reports on clinical challenges faced during the rehabilitation of custom ocular prosthesis. Each of these cases relate the challenges of making ocular impressions for an improved retention and support of ocular prosthesis and presents the significance of scleral contouring in overcoming cosmetic defects of the eye. In addition, evaluation of scleral wax pattern, methods of iris location and scleral characterization methods in ocular rehabilitation are further discussed. [ABSTRACT FROM AUTHOR]

The study on the magnification of the clear acrylic resin in prosthetic dentistry is important but lacking. Hence, this research aimed to investigate the magnification of the iris in the ocular prosthesis with various thicknesses of clear heat cure acrylic resin. A total of 60 ocular prostheses were divided into six groups with various thicknesses of clear heat cure acrylic resin over the iris; T0 (control): no acrylic resin, T1: 2, T2: 4, T3: 6, T4: 8, and T5: 10 mm of clear acrylic resin over the iris. Each ocular prosthesis was manufactured from white acrylic, with a 10.250 mm iris. Then, the clear heat cure resin was placed over the iris, cured, then polished. The final diameter of the iris was measured with a vernier caliper. The sizes of the iris were compared among various groups using one-way ANOVA, and a significant level was chosen at p value = 0.01. The mean sizes of iris were T0 = 10.25, T1 = 10.92, T2 = 11.26, T3 = 11.91, T4 = 12.75, and T5 = 13.43 mm. The size of the iris was significantly different among the group (p < 0.0001). The magnification of the iris for different groups was 1.06 for T1, 1.10 for T2, 1.16 for T3, 1.24 for T4, and 1.31 for T5. The magnification of the iris increased as the thickness of clear heat cure acrylic resin over the iris is increased on the ocular prosthesis. [ABSTRACT FROM AUTHOR]

Introduction. When developing ocular prostheses, a number of problems arise, one of which is the construction of the connection between the hard optical part and the soft corneal tissue. Their Young's modules can differ by three orders of magnitude. In this case, the problem arises of creating an intermediate layer, possibly with gradient properties, whose purpose is to exclude injury to soft biological tissues. Two types of keratoprostheses are considered: the first type with a support plate and the second type with an intermediate functionally gradient layer. The stress-strain state of the prosthesis is calculated for the first type. For the second type, analytical and finite element modeling of the interaction of a cylindrical optical prosthesis, an intermediate inhomogeneous layer, and the cornea was carried out in the elastic media. Two versions are considered: discounting the curvature (circular plate or plate) and with account of the curvature (spherical dome or shell). The work objective is to study the stress-strain state of the keraprosthesis and cornea in the contact area.Materials and Methods. Mathematical models of the structures under consideration are the boundary value problems of the linear elasticity theory. The analytical solution is constructed for a simplified model in the form of a composite circular plate. Spatial three-dimensional problems and axisymmetric problems are solved by the finite element method. Finite element modeling of the considered structures was performed in the CAE package ANSYS and ACELAN. Results. CAD models of keratoprostheses with conditions of fixing and loading are constructed. The load acting on the keraprosthesis under the effect of intraocular pressure was determined. The stress-strain state of the keratoprosthesis and cornea elements was calculated. Special attention was paid to the area of its contact with the keratoprosthesis.Discussion and Conclusions. The results of calculating the axial displacements and mechanical stresses in the first type of keratoprosthesis show that the selected geometric parameters meet the kinematic and strength requirements. The proposed models of the deformed state of soft biological tissues provide assessing their injury when using a keratoprosthesis of the second type, as well as selecting the geometric parameters and gradient properties of the intermediate layer.