PowerPoint Presentation
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By G. VineethIII MDSEye Prosthesis
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ContentsIntroductionHistoryTypes of eye prosthesesPatient
evaluationTreatment planningTechniques of impressionTechniques of
fabricationMethods of
retentionMaintenanceComplicationsConclusionReferences
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Introduction
Defects of the eye
Marian Pauly MS, DNB, Giridhar A, MS, Iby P. Varghese. Ocular
prosthesis. Kerala Journal of Opthalmology 2011; 23(4);
339-41Thomas D Taylor, editor. Clinical maxillofacial prosthetics.
Quintessence Publishing Co; 2000.
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StigmatisationOrbital eviscerationOrbital enucleationIncreased
life expectancy & effort to sustain the competition increased
demand on prosthodontists4
HistoryIndians 5600 BCIran 2900 BCEgyptians 500 BCEuropeans 1500
ADMaterials used
Wikipedia: InternetSanjayagouda 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: 5762
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5600 BC - artificial eye or eye transplant in Shalivahan Shaka
Parva in the book called Garbhopanishad.444 AD - eye surgeries were
performed in Nalanda Vidyapith under Shri Nagarjunbharda.632 AD -
Shri Charak, Shri Shushrut and Shri Vagbhat operated to correct
disfigurements.633 AD - King Shashankdev of Vikramshila region has
awarded an eye made of gold as a trophy to Acharya Prashastpad for
his work in eye surgery on patients who had lost their eyes due to
small poxSince 1446 Portuguese Doctors introduced their system of
medicine. From 1670 the British introduced the Greek Medicine which
is followed to this day.18th and 19th centuries cryolite glass eyes
by Ludwig Muller, majorly produced by Germany, PMMA popularized in
Europe and GermanyThe stock eyes available in the market today are
made from low-grade plastic5
Types of Eye prostheses
Conformers
Ocular prosthesis
Orbital ProsthesisThomas 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
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Conformer : word materialOcular prosthesis: Orbital
prosthesisFacial prosthesisOrbital prosthesis combined with
Obturator6
Patient evaluationFor ocular defectsPrognosis estimationPhysical
evaluationMuscular evaluationDesires and expectations of the
patientCounselling the patientFor orbital defectsPre-operative
evaluation better than post-operativeCT, 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
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Treatment planningPatient centered modelMultidisciplinaryInitial
visit determine treatment needs and confirm them with
patientDiscuss these needs with team members process and outcomeAll
the pre-requisites should be plannedPatient confirms regarding the
procedure after consultationSigned consentStart treatment
Thomas D Taylor, editor. Clinical maxillofacial prosthetics.
Quintessence Publishing Co; 2000.
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Core team and full team8
Treatment planning - stepsPlanning RetentionMoulage impression
and working cast fabrictionPattern fabrication and
try-inCraniofacial implants placement followed by impressionCast
modificationPattern try-inProcessingInsertion and maintenance
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Methods of retentionExtra-ocular musclesAdhesivesMechanical :
Eyeglasses/SpectaclesMagnetsImplants: 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), 863-65Neeraj Khatkar et al. Magnets in
prosthetic dentistry. Journal of Dental Sciences & Oral
Rehabilitation 2013; 12-13.
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location and size of the defect, tissue mobility or lack there
of, undercuts, and the material weight of the final
prosthesis.nonporous silicone, hydroxyapatite, or porous
polyethylene implantsThe nonporous, silicone implant ensures eye
motility through surface tension at the conjunctival-prosthetic
interface that is transmitted directly to the implant. Silicone
implants come in sizes ranging from 14mm-20mm. Hydroxyapatite and
polyethylene are both porous implants. Adv - fibrovascular ingrowth
and permanent integration with orbital tissues10
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
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location and size of the defect, tissue mobility or lack there
of, undercuts, and the material weight of the final
prosthesis.11
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):132136
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http://www.ocularist.org/resources_surgical_procedures.asp;
American society of ocularists: Internet
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Techniques of impressionStock tray impression technique
Thomas D Taylor, editor. Clinical maxillofacial prosthetics.
Quintessence Publishing Co; 2000.
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Techniques of impressionExternal tray impression technique
Thomas D Taylor, editor. Clinical maxillofacial prosthetics.
Quintessence Publishing Co; 2000.
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Techniques of impression
Thomas D Taylor, editor. Clinical maxillofacial prosthetics.
Quintessence Publishing Co; 2000.
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Techniques of impression
3 D Laser Scanning3 D Optical Scanning3 D ImageA. M. Bhat.
Recent advances in the modelling of extraoral defects. J Ind
Prosthodont Soc 2005; 5(4); 180-184
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Techniques of fabricationPaper Iris Disk technique
Thomas D Taylor, editor. Clinical maxillofacial prosthetics.
Quintessence Publishing Co; 2000.
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Techniques of fabricationBlack Iris Disk technique
Thomas D Taylor, editor. Clinical maxillofacial prosthetics.
Quintessence Publishing Co; 2000.
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Techniques of fabrication
Thomas D Taylor, editor. Clinical maxillofacial prosthetics.
Quintessence Publishing Co; 2000.
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Color matching
Thomas D Taylor, editor. Clinical maxillofacial prosthetics.
Quintessence Publishing Co; 2000. ArmamentariumColor formulation
and mixing machineSpectrophotometer
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Identifying and mixing base colorTrial and error
methodComputerized color formulation21
Rapid prototyping
Ing Andreas Gebhardt. Textbook; Short course on rapid
prototyping. 2010
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Procedure
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Procedure
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Recent trend Bionic Eye
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MaintenenceAdjustment to the prosthesisPeriod of wearRemoval and
replacementCleaningRecallG. R. Parr, B. M. Goldman, and A. 0. Rahn.
Postinsertion care of the ocular prosthesis. J Prosthet Dent 1983;
49(2); 220-224
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ComplicationsTissue irritationInadequate peri-orbital
supportRecurrence of tumorImplant exposureConjunctival
thinningDischarge Pyogenic granuloma formation (excess healing
tissue formation), Rarely persistent pain or discomfort
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ConclusionTo meet challenges and surpass them is the basic means
survival of the fittest.With efficiency and uncompromising efforts,
this task becomes easier.
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ReferencesMarian Pauly MS, DNB, Giridhar A, MS, Iby P. Varghese.
Ocular prosthesis. Kerala Journal of Opthalmology 2011; 23(4);
339-41Thomas 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
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ReferencesSanjayagouda 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: 5762Wikipedia: InternetNeeraj 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):132136http://www.ocularist.org/resources_surgical_procedures.asp;
American society of ocularists: InternetA. M. Bhat. Recent advances
in the modelling of extraoral defects. J Ind Prosthodont Soc 2005;
5(4); 180-184Ing Andreas Gebhardt. Textbook; Short course on rapid
prototyping. 2010
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