When an eye is removed, an
orbital implant is used by the oculo-facial surgeon to replace
the area in the orbit (bony cavity) that was occupied by the
eye. This small, spherical implant maintains the natural
structure of the orbit and provides support for the artificial
eye. The implant is inserted during the surgical procedure. It
is not visible to the patient or to anyone else after the
procedure is completed.
An artificial eye is used to
restore the natural appearance of the eye and surrounding
tissues, and is the visible part of the surgical changes to the
socket. Artificial eyes are usually made of plastic
(acrylic) or glass. Custom artificial eyes are hand-crafted by
highly skilled ocularists (eye makers) to precisely match the
look of the natural eye.
While artificial eyes have been
made for thousands of years, the first orbital implants were
developed about 100 years ago. These small spheres of glass or
gold were later replaced by plastic or silicone spheres; but
until recently, the basic design of these "first-generation"
implants had changed little over the years.
The need for a better implant
The first-generation implants
were a major improvement for those wearing an artificial eye,
but they were unable to deliver natural movement to the
artificial eye.
This lack of movement was a major
obstacle to restoring a natural appearance, which made the
adjustment to wearing an artificial eye much more difficult.
The first-generation implants
also tended to drift (migrate) in the orbit and were often
rejected (extruded) by the tissues of the body, making further
surgeries necessary. These problems inspired researchers to
search for a better orbital implant.
Integrated Orbital Implants
New surgical procedures have been
developed that now may enable the ophthalmic plastic surgeon to
achieve acceptable movement of the artificial eye even if the
eye was removed years ago. The newest orbital implants are
called integrated implants. Some examples of these new
integrated orbital implants include Bio-Eye Hydroxyapatite
orbital implant, FCI3 synthetic coral orbital implant,
Bio-ceramic aluminum oxide implant and Medpor porous
polyethylene orbital implant.
Although they may be made from a
variety of substances, all of these implants are porous; they
have tiny holes in their structure which allows the patients own
blood vessels and tissues to actually grow into them. Once this
happens, the implants actually becomes integrated in the
patient. What this means in practice is that this integration
essentially eliminates the possibility of future migration and
extrusion and decreases the chance of infection, all of which
were not uncommonly seen with the first generation implants.
Dr. Kass works closely with the ocularist who fabricates and
fits the prosthesis (artificial eye) to insure that the patient
who has lost an eye has the benefit of the latest advances in
custom-made artificial eyes and fitting techniques.
Natural movement of the eyes is
of utmost importance to the patient whose eye has to be removed.
It understandable that the patient wants as natural a look as
possible. Recent advances in ocular implant technology are
staggering.
Final Reminders
To effectively treat patients who
have lost an eye or who wear an ocular prosthesis requires a
special understanding of the anatomy and pathophysiology of the
orbit. Fellowship in the American Society of Oculo-facial
Plastic and Reconstructive Surgery (ASOPRS) indicates that the
surgeon has greatest specialized training and expertise in
treating these problems.
If you or someone you know has
lost an eye or is having problems, either functional or
cosmetic, wearing an ocular prosthesis, please consult with Dr.
Kass who is fully trained to treat this problem and has been in
practice in Tampa Bay for over 20 years.
