Bali Yashika, Kumar Ayush, Singh Ravpreet, Sharma Riddhi, Gill Tarunpreet, Kalra Vaishali
Department of Prosthodontics and Crown and Bridge, Subharti Dental College and Hospital, Swami Vivekanand Subharti University, Meerut, IND.
Department of Prosthodontics and Crown and Bridge, National Dental College and Hospital, Mohali, IND.
Cureus. 2024 Oct 27;16(10):e72485. doi: 10.7759/cureus.72485. eCollection 2024 Oct.
The eyes play a crucial role in vision and emotional expression, and their loss can profoundly affect appearance and psychological well-being. Eye loss may result from trauma, tumors, infections, malignancies, or congenital abnormalities. Surgical methods for removing an eye include enucleation, evisceration, and exenteration. When surgical reconstruction is insufficient, prosthetic rehabilitation becomes necessary, requiring collaboration among ophthalmologists, oral and maxillofacial surgeons, and prosthodontists. Ocular and orbital prostheses, which may be either prefabricated or custom-made, help maintain hygiene and monitor for tumor recurrence, significantly improving the patient's quality of life. We report two cases that describe a technique for fabricating a custom ocular and silicone-based orbital prosthesis, particularly useful for patients with defects caused by tumors or trauma. One case involved a five-year-old boy who sought treatment for an ocular prosthesis after enucleation of his left eye due to retinoblastoma. A custom prosthesis was crafted to accommodate the child's facial growth, and follow-up visits indicated positive aesthetic and psychological outcomes. Another case involved a 54-year-old man who had undergone exenteration of his left eye eight years prior due to low-grade myxofibrosarcoma. Extensive preoperative planning and patient counseling were undertaken, and a custom magnet-retained silicone-based orbital prosthesis was designed to match his facial features. Multiple adjustments were made for comfort and functionality, and the patient reported significant improvements in social interactions and self-esteem. These cases underscore the importance of personalized care and teamwork in prosthetic rehabilitation. For many years, artificial eyes have been replaced with either stock or custom prostheses, with custom options generally providing a more accurate and aesthetically pleasing result, especially in patients who have undergone enucleation or exenteration. While implant-retained prostheses can enhance outcomes, conventional ocular and orbital prostheses remain practical, cost-effective options that support psychosocial well-being, even though they do not restore vision. In pediatric cases, it is critical to regularly adjust the prosthesis to accommodate the child's growth and prevent complications. Room temperature vulcanized (RTV) silicone is favored for its flexibility and compatibility, though it requires routine maintenance due to wear and discoloration. Samarium-cobalt magnets, commonly used for retention, offer strong stability but can corrode over time, necessitating encapsulation and regular inspections. Despite some limitations, traditional prostheses are highly effective in ocular rehabilitation, and advances in computer-aided designing-computer-aided manufacturing (CAD-CAM) technology now offer enhanced solutions for addressing such defects. Rehabilitating defects with custom prostheses is a transformative process, significantly improving patients' lives. By restoring natural appearance and function, these prostheses not only enhance physical aesthetics but also boost emotional well-being and social confidence. The precise creation and fitting of these custom devices ensure a perfect match, leading to greater comfort and patient satisfaction.
眼睛在视觉和情感表达中起着至关重要的作用,失去眼睛会对外观和心理健康产生深远影响。失明可能由创伤、肿瘤、感染、恶性肿瘤或先天性异常引起。摘除眼睛的手术方法包括眼球摘除术、眼内容剜除术和眼眶内容物剜除术。当手术重建不足时,假体康复就变得必要,这需要眼科医生、口腔颌面外科医生和修复牙科医生之间的协作。眼和眼眶假体可以是预制的,也可以是定制的,有助于保持卫生并监测肿瘤复发,显著提高患者的生活质量。我们报告了两例描述定制眼和硅胶基眼眶假体制造技术的病例,该技术对因肿瘤或创伤导致缺陷的患者特别有用。一例涉及一名五岁男孩,他因视网膜母细胞瘤摘除左眼后寻求眼假体治疗。制作了一个定制假体以适应孩子的面部生长,随访显示美学和心理效果良好。另一例涉及一名54岁男性,他八年前因低度黏液纤维肉瘤接受了左眼眼眶内容物剜除术。进行了广泛的术前规划和患者咨询,并设计了一个定制的磁体固定硅胶基眼眶假体以匹配他的面部特征。为了舒适度和功能进行了多次调整,患者报告社交互动和自尊有显著改善。这些病例强调了个性化护理和团队合作在假体康复中的重要性。多年来,义眼已被预制或定制假体所取代,定制选项通常能提供更准确、更美观的效果,尤其是在接受眼球摘除术或眼眶内容物剜除术的患者中。虽然植入物固定假体可以提高效果,但传统的眼和眼眶假体仍然是实用、经济有效的选择,能支持心理社会健康,尽管它们不能恢复视力。在儿科病例中,定期调整假体以适应孩子的生长并预防并发症至关重要。室温硫化(RTV)硅胶因其柔韧性和兼容性而受到青睐,不过由于磨损和变色需要定期维护。常用于固定的钐钴磁体提供强大的稳定性,但随着时间推移可能会腐蚀,需要封装和定期检查。尽管存在一些局限性,传统假体在眼部康复中非常有效,计算机辅助设计 - 计算机辅助制造(CAD - CAM)技术的进步现在为解决此类缺陷提供了更好的解决方案。用定制假体修复缺陷是一个变革性的过程,能显著改善患者的生活。通过恢复自然外观和功能,这些假体不仅增强了身体美学,还提升了情绪健康和社会信心。这些定制装置的精确制作和适配确保了完美匹配,带来更高的舒适度和患者满意度。