The Design and Manufacture of Custom Ocular Prostheses (COPs) Based on Computer-Aided Semi-automation Workflow

Background: It is important to correct the ocular disfigurement by wearing prostheses as soon as possible after healing from the eye enucleation surgery. This study aimed to develop a new computer-aided approach to fabricate custom ocular prostheses (COPs) with higher accuracy and efficiency and to fit different anophthalmia sockets. Results: Five patients underwent enucleation surgery from November 2018 to October 2020 were enrolled in the study. The semi-automatic design and fabrication workflow of COPs was based on the conjunctival sac impression, combined with Computer-aided design/Computer-aided manufacture (CAD/CAM) workflow, which involves computer image analysis, reverse engineering (RE), and 3-dimensional (3D) printing technologies. The height of palpebral fissure in the artificial eye group was 0.8000 ± 0.09529, N=5.The height of palpebral fissure in the healthy eye group was 0.7660 ± 0.1147, N=5, and there was no statistical difference between the two groups (p>0.05). The artificial eye in the conjunctival sac had a good effect on the reconstruction of orbital fullness. Both of the vertical activity and horizontal activity of COPs is smaller than that of healthy eyes (p<0.05).Conclusions: COPs made by RE and 3D printing technologies can effectively make the COPs suitable for patients' conjunctival sac. This workflow improved the accuracy of the COPs, and also reduced patients’ waiting time, which is worthy to be popularized and applied.

The loss of an eye due to occupational injury: Two case studies of ocular prosthetic rehabilitation

BACKGROUND: Two patients received ocular injuries from rusted metallic projectiles at their industrial workplaces. Said injuries resulted in the loss of their eyes by evisceration surgeries to prevent fatal infections. CASE DESCRIPTION: The first case, a man in his twenties, received a stock conformer immediately after surgery and started prosthetic therapy within 2 months. The second case, a man in his forties, started prosthetic therapy after 10 years. Definitive custom ocular prostheses were fabricated and relined according to conventional protocol. RESULTS: On issue of the prosthesis, there was adequate retention, aesthetics and stability to extra-ocular movements and treatment was considered successful for both cases. However, follow-ups showed noticeable prosthetic eye movements for case 1 which, to some extent mimicked the physiologic movement of its fellow natural eye. Case 1 adjusted to his prosthesis better while case 2 was still adjusting with little to no physiologic movement. CONCLUSION: Prosthetic rehabilitation should be started as early as possible to obtain optimum rehabilitative results.

The Design and Manufacture of Custom Ocular Prostheses (COPs) Based on Computer-Aided Semi-automation Workflow

Background It is important to correct the ocular disfigurement by wearing prostheses as soon as possible after healing from the eye enucleation surgery. This study aimed to develop a new computer-aided approach to fabricate custom ocular prostheses (COPs) with higher accuracy and efficiency and to fit different anophthalmia sockets. Results Five patients underwent enucleation surgery from November 2018 to October 2020 were enrolled in the study. The semi-automatic design and fabrication workflow of COPs was based on the conjunctival sac impression, combined with Computer-aided design/Computer-aided manufacture (CAD/CAM) workflow, which involves computer image analysis, reverse engineering (RE), and 3-dimensional (3D) printing technologies. The height of palpebral fissure in the artificial eye group was 0.8000 ± 0.09529, N = 5.The height of palpebral fissure in the healthy eye group was 0.7660 ± 0.1147, N = 5, and there was no statistical difference between the two groups (p > 0.05). The artificial eye in the conjunctival sac had a good effect on the reconstruction of orbital fullness. Both of the vertical activity and horizontal activity of COPs is smaller than that of healthy eyes (p < 0.05). Conclusions COPs made by RE and 3D printing technologies can effectively make the COPs suitable for patients' conjunctival sac. This workflow improved the accuracy of the COPs, and also reduced patients’ waiting time, which is worthy to be popularized and applied.

Non-surgical Approach to Improve Prognosis of Ocular Prostheses for Grade III and IV Contracted Sockets

Patients with Grade III or IV contracted ocular sockets, most often due to Post Enucleation Socket Syndrome (PESS), suffer from loss of ocular volume along with a lax lower eyelid, which complicates prosthetic rehabilitation in terms of fit as well as aesthetics. Surgical correction is preferable, though not always feasible. A non-invasive approach for prosthetic rehabilitation of such difficult cases, using bandaging and progressively larger conformers is described here.

Profile of Custom Ocular Prosthesis Users in a Tertiary Eye Care Centre in Nepal

Objective: To analyze the profile of custom ocular prosthesis users in Nepal. Methodology: This was a retrospective study done at Drishti Eye Care System, Nepal from January 2019 to June 2019. One eyed subject who used custom prosthesis for minimum of 6 months or above of any age group were recruited in the study. Information regarding laterality, cause of loss of eye, reason for opting ocular prosthesis and source of information regarding ocular prostheses were collected from the participants. A set of questions were asked to the participants through telephonic interview after the duration of 3 to 6 months wear of ocular prosthesis to collect information on any symptoms after the wear. Results: Mean age of subjects in the study was 31.35±16.59 years (range 1.5 years – 78 years), 46.7% (n=14) were male and 53.3% (n=16) were female. Trauma was the most common cause of loss of the eye in 43.3% (n=13), followed by congenital loss and eye infections in 16.7% (n=5). 43.3% (n=13) of the subjects had lost their right eye and 56.7% (n=17) subjects had lost their left eye. 33.3% (n=10) of the subjects didn’t have any symptoms with the use of prosthesis. Milder form of symptoms like small appearance, mild discharge and pain were major complaints after the wear. Conclusion: There is a need of best prosthetic rehabilitation for the anophthalmic patients.