Lawrence G. Kass M.D.

OCULOPLASTIC & FACIAL

COSMETIC SURGERY


727.522.3223

St. Petersburg / Clearwater

Eye Prosthesis Plastic Surgery

At times it becomes necessary to surgically remove an eye that has become severely damaged by disease or injury. Such a loss is emotionally upsetting and difficult to accept. An attractive artificial eye that fits properly and moves well helps one overcome this crisis.


ORBITAL IMPLANTS AND ARTIFICIAL EYES


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 Clearwater for over 20 years.