Eye

Prosthesis
 Contents
• Introduction
• History
• Types of eye prostheses
• Patient evaluation
• Treatment planning
– Techniques of impression
– Techniques of fabrication
– Methods of retention
– Maintenance
• Complications
• Conclusion
• References
 Introduction

Defects of the
eye

Marian Pauly MS, DNB, Giridhar A, MS, Iby P. Varghese. Ocular prosthesis. Kerala Journal of Opthalmology 2011; 23(4); 339-41
Thomas D Taylor, editor. Clinical maxillofacial prosthetics. Quintessence Publishing Co; 2000.
 History
• Indians – 5600 BC

• Iran – 2900 BC

• Egyptians – 500 BC

• Europeans – 1500 AD

• Materials used
Wikipedia: Internet
Sanjayagouda B. Patil, Roseline Meshramkar, B. H. Naveen and N. P. Patil. Ocular prosthesis: a brief review and fabrication of an ocular prosthesis for a geriatric
patient. Gerodontology 2008; 25: 57–62
 Types of Eye prostheses

Ocular prosthesis

Orbital Prosthesis

Conformers

Thomas D Taylor, editor. Clinical maxillofacial prosthetics. Quintessence Publishing Co; 2000.
Sykes, Essop and Veres. Use of custom made conformers in the treatment of ocular defects. J Prosthet Dent 1999;82:362-5
 Patient evaluation
• For ocular defects
– Prognosis estimation
– Physical evaluation
– Muscular evaluation
– Desires and expectations of the patient
– Counselling the patient
• For orbital defects
– Pre-operative evaluation better than post-operative
– CT, MRI, FNAC useful.

Thomas D Taylor, editor. Clinical maxillofacial prosthetics. Quintessence Publishing Co; 2000.
E. L. DaBreo, and David E. Schuller. Surgical and prosthetic considerations in the management of orbital tumors. J Prosthet Dent 1992; 67(1); 106-12
Treatment planning
• Patient centered model
• Multidisciplinary
• Initial visit – determine treatment needs and confirm them with
patient
• Discuss these needs with team members – process and outcome
• All the pre-requisites should be planned
• Patient confirms regarding the procedure after consultation
• Signed consent
• Start treatment

Thomas D Taylor, editor. Clinical maxillofacial prosthetics. Quintessence Publishing Co; 2000.
Treatment planning - steps
• Planning Retention
• Moulage impression and working cast fabriction
• Pattern fabrication and try-in
• Craniofacial implants placement followed by impression
• Cast modification
• Pattern try-in
• Processing
• Insertion and maintenance
 Methods of retention
• Extra-ocular muscles

• Adhesives

• Mechanical : Eyeglasses/Spectacles

• Magnets

• Implants: Bar and clip attachments or magnetic attachments

Sameera R Shaikh, Pravinkumar G Patil, Santosh Puri. A modified technique for retention of orbital prosthesis. Indian Journal of Dental Research 2011, 22(6), 863-65
Neeraj Khatkar et al. Magnets in prosthetic dentistry. Journal of Dental Sciences & Oral Rehabilitation 2013; 12-13.
 Modified retention

Sameera R Shaikh, Pravinkumar G Patil, Santosh Puri. A modified technique for retention of orbital prosthesis. Indian Journal of Dental Research 2011, 22(6), 863-65
 Modified retention

Gunjan Pruthi, Veena Jain & Swati Sikka. A Novel Method for Retention of an Orbital Prosthesis in a Case with Continuous Maxillary and Orbital Defect. J Ind Prosthodont
Soc 2010; 10(2):132–136
http://www.ocularist.org/resources_surgical_procedures.asp; American society of ocularists: Internet
Techniques of impression
• Stock tray impression technique

Thomas D Taylor, editor. Clinical maxillofacial prosthetics. Quintessence Publishing Co; 2000.
Techniques of impression
• External tray impression technique

Thomas D Taylor, editor. Clinical maxillofacial prosthetics. Quintessence Publishing Co; 2000.
Techniques of impression

Thomas D Taylor, editor. Clinical maxillofacial prosthetics. Quintessence Publishing Co; 2000.
Techniques of impression

3 D Laser Scanning 3 D Optical Scanning 3 D Image

A. M. Bhat. Recent advances in the modelling of extraoral defects. J Ind Prosthodont Soc 2005; 5(4); 180-184
Techniques of fabrication
• Paper Iris Disk technique

Thomas D Taylor, editor. Clinical maxillofacial prosthetics. Quintessence Publishing Co; 2000.
Techniques of fabrication
• Black Iris Disk technique

Thomas D Taylor, editor. Clinical maxillofacial prosthetics. Quintessence Publishing Co; 2000.
Techniques of fabrication

Thomas D Taylor, editor. Clinical maxillofacial prosthetics. Quintessence Publishing Co; 2000.
 Color matching

Armamentarium

Color formulation and

mixing machine
S
Thomas D Taylor, editor. Clinical maxillofacial prosthetics. Quintessence Publishing Co; 2000. p
e
Rapid prototyping

Ing Andreas Gebhardt. Textbook; Short course on rapid prototyping. 2010

Procedure
Procedure
Recent trend – Bionic Eye
 Maintenence
• Adjustment to the prosthesis

• Period of wear

• Removal and replacement

• Cleaning

• Recall
G. R. Parr, B. M. Goldman, and A. 0. Rahn. Postinsertion care of the ocular prosthesis. J Prosthet Dent 1983; 49(2); 220-224
Complications
• Tissue irritation
• Inadequate peri-orbital support
• Recurrence of tumor
• Implant exposure
• Conjunctival thinning
• Discharge
• Pyogenic granuloma formation (excess healing tissue formation),
• Rarely persistent pain or discomfort
 Conclusion
To meet challenges and surpass them is the basic means survival of
the fittest.
With efficiency and uncompromising efforts, this task becomes
easier.
 References
• Marian Pauly MS, DNB, Giridhar A, MS, Iby P. Varghese. Ocular prosthesis. Kerala
Journal of Opthalmology 2011; 23(4); 339-41
• Thomas D Taylor, editor. Clinical maxillofacial prosthetics. Quintessence Publishing
Co;
2000.
• E. L. DaBreo, and David E. Schuller. Surgical and prosthetic considerations in the
management of orbital tumors. J Prosthet Dent 1992; 67(1); 106-12.
• Sameera R Shaikh, Pravinkumar G Patil, Santosh Puri. A modified technique for
retention of orbital prosthesis. Indian Journal of Dental Research 2011, 22(6),
863-65.
• G. R. Parr, B. M. Goldman, and A. 0. Rahn. Postinsertion care of the ocular prosthesis.
J Prosthet Dent 1983; 49(2); 220-224
• Sykes, Essop and Veres. Use of custom made conformers in the treatment of
ocular defects. J Prosthet Dent 1999;82:362-5
References
• Sanjayagouda B. Patil, Roseline Meshramkar, B. H. Naveen and N. P. Patil. Ocular
prosthesis: a brief review and fabrication of an ocular prosthesis for a geriatric
patient. Gerodontology 2008; 25: 57–62
• Wikipedia: Internet
• Neeraj Khatkar et al. Magnets in prosthetic dentistry. Journal of Dental Sciences &
Oral Rehabilitation 2013; 12-13.
• Gunjan Pruthi, Veena Jain & Swati Sikka. A Novel Method for Retention of an
Orbital Prosthesis in a Case with Continuous Maxillary and Orbital Defect. J Ind
Prosthodont Soc 2010; 10(2):132–136
• http://www.ocularist.org/resources_surgical_procedures.asp; American society of
ocularists: Internet
• A. M. Bhat. Recent advances in the modelling of extraoral defects. J Ind
Prosthodont
Soc 2005; 5(4); 180-184