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 Table of Contents  
CASE REPORT
Year : 2021  |  Volume : 6  |  Issue : 1  |  Page : 24-25

Prosthetic management of anophthalmic socket with an ocular defect


1 Consultant Prosthodontist and Implantologist, Department of Prosthodontics, Moulana Hospital, Perintlmanna, Kerala, India
2 Assistant Professor, Department of Prosthodontics, St. Gregorious Dental College, Ernakulam, Kerala, India
3 Assistant Professor, Department of Periodontics, Educare Institute of Dental Sciences, Malappuram, Kerala, India

Date of Submission29-Apr-2021
Date of Acceptance07-May-2021
Date of Web Publication14-Jun-2021

Correspondence Address:
Dr. M Shamna
Department of Periodontics, Educare Institute of Dental Sciences, Malappuram - 676 504, Kerala
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/ijmo.ijmo_7_21

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  Abstract 


Eyes are generally the first feature of the face to be noticed. Several ocular and orbital disorders require surgical intervention that may result in ocular defects. In this case report, an easy and economical method of fabricating an ocular prosthesis with improved esthetics and color matching for a 4-year-old child diagnosed with retinoblastoma is described.

Keywords: Anophthalmic, ocular, prosthetic


How to cite this article:
Muhasin C, Sreenath I R, Shamna M. Prosthetic management of anophthalmic socket with an ocular defect. Int J Med Oral Res 2021;6:24-5

How to cite this URL:
Muhasin C, Sreenath I R, Shamna M. Prosthetic management of anophthalmic socket with an ocular defect. Int J Med Oral Res [serial online] 2021 [cited 2021 Nov 29];6:24-5. Available from: http://www.ijmorweb.com/text.asp?2021/6/1/24/319421




  Introduction Top


A person's face is the source of much information. It shows emotion, demonstrates intellect, and is a vehicle for communication. Eyes are generally the first feature of the face to be noticed. The disfigurement resulting from loss of an eye can cause significant psychological as well as social consequences.

Removal of this organ may be indicated in cases of a severe trauma; congenital abnormality; or disease such as an infection, a tumor, or untreatable painful glaucoma either by enucleation, evisceration, or exenteration.[1],[2] The goal of any ocular prosthetic procedure is to present the patient to the society with a normal appearance. An ocular prosthesis can be either ready-made (stock) or custom-made.[3],[4]

Unlike glass eyes which were earlier used, the acrylic resin eyes were lightweight, easy to fit and adjust, unbreakable, translucent, easily fabricated, had intrinsic and extrinsic coloring capabilities, and was inert to the socket secretions.[1],[5] In this case report, an easy and economical method of fabricating an ocular prosthesis with improved esthetics and color matching is described.


  Case Report Top


A 4-year-old male child with a history of enucleation of the right eye due to retinoblastoma reported to the Department of Prosthodontics of AJ Institute of dental sciences, Mangalore.

Clinical procedure

Impression procedures were carried out by elastomeric impression material (ultralight body) which was injected into the eye socket using an automatic gun, and the gun tip was held in position till the impression set. After removal of the impression from the eye, boxing of which was done using the three pour technique [Figure 1]. A base of dental stone was used for the investment of the impression. After the setting of the first pour, the second and third pour was done. For orientation of the three sections, ditches were made in the first pour of dental stone.{Figure 1}

Wax pattern fabrication was done by pouring molten wax into the socket mold. A stock eye which matched the iris and pupil of the patient was selected and trimmed, while the color of the sclera was matched with the particular shade of clear acrylic. The try-in was done and the required modifications were carried out.

After wax try-in, the prosthesis was invested, dewaxed, and packed with heat cure clear acrylic. After the curing process, characterization was done according to the left eye. Brown stains were incorporated into the sclera of the prosthesis using water color, and red nylon threads were placed on the lateral, medial, and superior aspect of the prosthesis to demonstrate veins. The threads were temporarily stabilized using a small quantity of cold cure monomer. Heat cure clear acrylic was mixed in dough stage, and a thin layer was placed into the mold space and heat cured. Then, the prosthesis was removed from the flask, trimmed, and polished and tried in the patient's eye [Figure 2].{Figure 2}

Maintenance of the prosthesis

The patient is instructed to wear the prosthesis throughout the day. Prosthesis should be washed with mild soap once every 1 or 2 weeks. With the prosthesis removed, the soft tissues of the socket have to be rinsed with an ophthalmic irrigation solution and examined for irritation or infection. The prosthesis should be repolished immediately as well as periodically during routine follow-up examinations.


  Discussion Top


Before the introduction of methyl methacrylate ocular prostheses, most ocular prostheses were constructed of glass.[6] Because glass prostheses could not be changed in size or dimension, the clinician's supply became known as stock eyes.[7] Burner et al.[8] stated that a prefabricated resin eye should not be used in enucleated sockets because intimate contact between the ocular prosthesis and the tissue bed is needed to distribute pressure equally. However, when the prosthesis is customized to the patient using a proper impression technique, distribution of pressure should be equal to accommodate a custom eye technique. In addition, intimate adaptation of the modified prosthesis to the tissue surface of the defect increases the movement of the prosthesis and enhances its natural appearance.[9],[10]


  Conclusion Top


The resulting prosthesis was esthetic and comfortable compared to a stock prosthesis. Furthermore, it is a time and cost-effective technique.

Declaration of patient consent

The authors certify that they have obtained all appropriate patient consent forms. In the form the patient (s) has/have given his/her/their consent for his/her/their images and other clinical information to be reported in the journal. The patients understand that their names and initials will not be published and due efforts will be made to conceal their identity, but anonymity cannot be guaranteed.

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.



 
  References Top

1.
Thakkar P, Patel J, Sethuraman R, Nirmal N. Custom ocular prosthesis: A palliative approach. Indian J Palliat Care 2012;18:78-83.  Back to cited text no. 1
  [Full text]  
2.
Mallikarjuna R, Aishwarya C, Debopriya C, Mallikarjuna Dm, Swetha V, Savita D, et al. Ocular prosthesis-A simplified technique. Austin J Clin Case Rep 2014;1:1061.  Back to cited text no. 2
    
3.
Cevik P, Dilber E, Eraslan O. Different techniques in fabrication of ocular prosthesis. J Craniofac Surg 2012;23:1779-81.  Back to cited text no. 3
    
4.
Kumar Ch S, Sajjan CS. Prosthetic management of an ocular defect. Contemp Clin Dent 2010;1:201-3.  Back to cited text no. 4
    
5.
Agarwal kk, Mall P, Alvi HA, Rao J, Singh K. Fabrication of custom made eye prosthesis for anopthalmic paediatric patients: 2 case reports. J Interdiscip Dent 2012;2;128-31.  Back to cited text no. 5
    
6.
Benson P. The fitting and fabrication of a custom resin artificial eye. J Prosthet Dent 1977;38:532-8.  Back to cited text no. 6
    
7.
Monoplex Bulletin No. 54. Stock Bridge; American Optical Corp.; 1973.  Back to cited text no. 7
    
8.
Burner J, Curtis TA, Firtell DN. Maxillofacial Rehabilitation. Prosthodontic and Surgical Considerations. St. Louis: The C V Mosby Co.; 1974.  Back to cited text no. 8
    
9.
Cain JR. Custom ocular prosthetics. J Prosthet Dent 1982;48:690-4.  Back to cited text no. 9
    
10.
Jamayet N, Taweewatchaikul Y, Srithavaj T, Alam MK. A new technique to correct the iris shading of ocular prosthesis. Int Med J 2013;20:621-2.  Back to cited text no. 10
    




 

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Introduction
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Discussion
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