Rehabilitación protésica en defecto ocular provocado por herpes zóster

El herpes zóster es el cuadro clínico constituido por las manifestaciones dermatológicas (erupción vesiculosa) y neurológica (dolor). Es la expresión de la recurrencia del virus varicela-zóster latente en los ganglios sensitivos, su aparición se favorece por el envejecimiento y la inmunosupresión con una prevalencia que se estima en un 20 %. Se describe los pasos clínicos para la confección de una prótesis ocular en el mejoramiento estético a un paciente con defecto ocular en ojo izquierdo provocado por herpes zoster. Se trata de un paciente masculino de piel blanca de 50 años de edad, que acudió a la consulta de prótesis del Policlínico Universitario Julio Antonio Mella de la provincia Camagüey remitido del Servicio de Oculoplastia del Hospital Universitario Manuel Ascunce Domenech con diagnóstico de defecto ocular izquierdo por evisceración como consecuencias de infección por herpes zoster y antecedente de inmunodepresión. El paciente expuso que la pérdida ocular fue por las complicaciones que se fueron sucediendo en la medida que se agravó su cuadro clínico. Además, refirió que presentaba dolor en la zona y que le irradiaba a la cabeza y que le preocupaba su estética. Se determinó la elaboración de una prótesis ocular acrílica para mejorar el aspecto estético, lo cual permitió que el paciente mejorara su autoestima y calidad de vida.

Herpes zoster is the clinical picture constituted by dermatological (vesicular rash) and neurological (pain) manifestations. It is the expression of the recurrence of the latent varicella-zoster virus in the sensitive ganglia, its appearance is favored by aging and immunosuppression with a prevalence estimated at 20%. We describe the clinical steps for the fabrication of an ocular prosthesis for the aesthetic improvement of a patient with ocular defect in the left eye caused by herpes zoster. This is a 50-year-old male patient with white skin, who came to the prosthesis consultation of the Julio Antonio Mella University Polyclinic in Camagüey province, referred from the Oculoplasty Service of the Manuel Ascunce Domenech University Hospital with a diagnosis of left ocular defect due to evisceration as a consequence of herpes zoster infection and a history of immunosuppression. The patient explained that the ocular loss was due to the complications that occurred as his clinical condition worsened. In addition, he reported that he had pain in the area that radiated to the head and that he was concerned about his esthetics. It was decided to make an acrylic ocular prosthesis to improve the esthetic aspect, which allowed the patient to improve his self-esteem and quality of life.

Modified Impression Technique of a Custom Made Hand Painted Iris For an Ocular Prosthesis: A Case Report

@#The enucleation of the eye due to variety of causes such as trauma, tumor and severe eye disease or infection has resulted to permanent defect of sight and aesthetic. Defects of the eye may include removal of a part of or the entire orbit which has affected patient’s psychology. Restoring the defect with pre-fabricated or custom-made ocular prosthesis will restore aesthetics and improves patient’s social confidence. This is a case report of construction a custom-made; hand painted iris of ocular prosthesis on a patient with missing left eye due to trauma using modified impression method. The case describes the process of constructing the custom-made ocular prosthesis with modification of impression technique to improve accuracy and fitting. It is aim to highlight the importance of custom-made prosthesis as compared to pre-fabricated ocular prosthesis on its property, fitting to eye socket, hygiene and aesthetic satisfaction.

Ocular Prosthesis � For Beginners

Background: The Ocular Prosthesis device is very important toprovide the best possible functional & cosmetic results. It is important to have a firm understanding of management of the anophthalmic socket & when to make appropriate referrals to the Ophtahlmic Surgeon. The Objectives In this review, the author will discuss about one of the component of Ocular Prosthesis ie. Orbital implants.Material & Methods:The patients who requires ocular prosthesis are selected as per the need & requirement, also on the basis of types of available implants.Results:One should follow the components& scenario for optimal outcome.Conclusions:An eye care professional should be aware of the entire structure & all the recent development involved in it. They also have to be empathetic and have a creative oulook in management of such conditions by using all the available resources.

The association between the duration of using ocular prosthesis and upper and lower conjunctival fornix depth

Background: Ocular prosthesis is needed to replace the content of eyeball lost due to several factors. Adequate retention of ocular prosthesis requires an adequate upper and lower conjunctival fornix depth. Objectives: The objectives of the study were to evaluate the association between the duration of using ocular prosthesis and upper and lower conjunctival fornix depth. Materials and Methods: A case–control study was conducted in 30 anophthalmic socket patients aged 22–77 that using ocular prosthesis more than 6 months. The contralateral eye with healthy socket was chosen as a control group. Upper and lower conjunctival fornix depth were measure using fornicometer. We design a fornix depth measurer for objective measurement of upper and lower conjunctival fornix depth. Results: From 30 anophthalmic socket patients, males were about 14 times more often than female, with the average age that was 51. The mean upper conjunctival fornix depth in males was 10.8 ± 0.6 and lower conjunctival fornix depth was 6.2 ± 0.8. The mean upper conjunctival fornix depth in females was 10.80± 0.6 and lower conjunctival fornix depth was 5.5 ± 0.7. There is medium relationship between upper conjunctival fornix depth and the duration of using prosthesis (cc = −0.435; P = 0.016) and there is high relationship between lower conjunctival fornix depth and the duration of using prosthesis (cc = −0.551; P = 0.002). Conclusions: There was a significant association between the duration of using ocular prosthesis and upper and lower conjunctival fornix depth.

Novel Method of Management of Pseudoptosis with Ocular Prosthesis

Introduction: Surgical removal of eye (enucleation) maycause disfigurement of the empty socket. Ptosis, an importantpost-operative complication, may be seen in Post-enucleationsocket syndrome or occurring alone. When the ptosis occursmainly due to loss of orbital volume, leading to loss of supportand drooping of the upper eyelid, the condition is pseuoptosis.This complicates the rehabilitation process with an ocularprosthesis compromising the cosmetic result. In this article, asimple modification of an ocular prosthesis is made to correctptosis in an enucleated socket with post-enucleation socketsyndrome.Case Report: An elderly male patient, suffering from postenucleation socket syndrome of left eye received a modifiedcustom ocular prosthesis. The anterior surface of the prosthesiswas over contoured to effectively position the upper eyelid ina superior position and prevent it from migrating downward.The modified prosthesis satisfactorily corrected the droopingof eyelid, restoring the natural appearance of the lost eye.Conclusion: In case of patients suffering from ptosis/pseudoptosis, a modified ocular prosthesis can replace thelost volume and support the eyelid in superior position, thuscorrecting the ptosis. In this article, a simple modification ofan ocular prosthesis has been demonstrated that rehabilitatesthe lost eye and restores the aesthetic need of a patient withpost-enucleation ocular defect

Impacto en la República Mexicana del Programa Extramuros de Prótesis Maxilofacial de la Facultad de Odontología UNAM de 1994 al 2018 (reseña histórica) / Impact of the UNAM Faculty of Dentistry Extramural Maxillofacial Prosthesis Program in Mexico from 1994 to 2018 (historical overview)

RESUMEN El propósito del presente escrito es hacer una reseña histórica del impacto e importancia que tienen los Programas Extramuros de la Especialidad de Prótesis Maxilofacial y para que exista un precedente narrativo documentado; así como resaltar la importancia de la atención médica que está encaminada a la rehabilitación física e incremento de la calidad de vida de los pacientes, lo cual figura en las declaraciones universales de salud pero que, debido a su alto costo, no hay una cobertura adecuada para los sistemas de salud gubernamentales; sin embargo, cuando se conjugan esfuerzos, voluntades y capacidades de diversas instituciones participantes, se puede lograr trascender y acercarse a una medicina de alto nivel.

ABSTRACT The goal of this document is to give an historical account of the importance and impact of the extramural program carried out by the UNAM Faculty of Dentistry Specialty of Maxillofacial Prosthetics to set a narrative precedent. The right of healthcare directed toward the physical rehabilitation and hence increased quality of life of patients is contained in the Article 25 of the Universal Declaration of Human Rights. However, the high cost of this type of care complicates its coverage on the part of Government health systems. But when the effort, the determination, and the capacity of various participating institutions blend, high-level medicine can reach to the most disadvantaged populations.

Combination of skin flap and silicone prosthesis for rehabilitation of a large orbital defect: A case report

Exenteration surgery greatly affects a person in terms of function, esthetics, and psychological trauma. In such cases, restoration by silicone orbital prosthesis is a well-accepted treatment option. However, this is a difficult task, necessitating personalized design of method for each patient. This case report describes the technique for fabrication of a silicone orbital prosthesis for a male patient with left orbital defect due to exenteration of a Grade 3 squamous cell carcinoma of the left eye and surrounding tissues. The patient was delivered with a satisfactory silicone orbital prosthesis having good retention and finish. Multidisciplinary management and team approach are crucial in providing precise and effective rehabilitation for improving the patient's quality of life and help them return to their normal social life.

Biocompatibilidade da resina acrílica de prótese ocular: análise in vitro e in vivo / Biocompatibility of ocular prosthesis acrylic resin: in vitro and in vivo analysis

O objetivo desse estudo foi avaliar a influência de diferentes ciclos e métodos de polimerização da resina acrílica (RA) branca de próteses oculares sobre a biocompatibilidade de células da conjuntiva humana e resposta inflamatória do tecido subcutâneo de ratos. Para isso, foram confeccionados corpos de prova em RA termopolimerizados em água aquecida (RNAA), por energia de microondas (RNTM) e quimicamente ativados (RNQA). Para a análise in vivo, a resposta inflamatória desses 3 grupos (n=20/grupo) foi avaliada no tecido subcutâneo de 20 ratos Wistar por 7, 15, 30 e 60 dias (d). Células inflamatórias foram contadas no tecido adjacente ao corpo de prova após coloração com hematoxilina e eosina. A análise imunohistoquímica foi realizada para a detecção de IL-1ß, IL-6, TNFα, IL-17 e CCL20. Para a análise in vitro, diferentes ciclos de polimerização para cada método citado foram avaliados, totalizando 11 grupos (n=8/grupo). Foram realizadas análises de grau de conversão (GC), MTT, Alamar Blue, ELISA, RT-PCR em tempo real e dupla marcação de Anexina V e iodeto de propídio. Dados quantitativos foram submetidos à Análise de Variância e ao teste de Tukey com significância de 5%. Os resultados qualitativos foram comparados visualmente. Na análise in vivo, houve infiltrado inflamatório moderado para os grupos RNTM e RNQA e leve para o grupo RNAA após 7 d. O infiltrado inflamatório e a imunomarcação dos alvos testados diminuiu gradativamente ao longo dos 60 d. O grupo RNTM exibiu mais células inflamatórias, com exceção do grupo RNAA, que apresentou mais eosinófilos e linfócitos após 15 d, e do grupo RNQA, onde foi observado mais macrófagos em 15 d e neutrófilos em 60 d. Os grupos RNAA e RNQA apresentaram maior imunomarcação de IL-1ß após 7 d. O grupo RNQA apresentou maior imunomarcação de IL-1ß (15 e 30 d), IL-6 (30 e 60 d), IL-17 (15 e 30 d) e TNF-α (7 d). Os grupos RNAA e RNTM apresentaram maior imunomarcação de TNF-α nos períodos de 15 e 30 d, enquanto o grupo RNTM, aos 60 d. Na análise in vitro, todos os grupos apresentaram proliferação celular maior que 75%. O ciclo longo de polimerização em microondas apresentou menor GC e percentual de proliferação celular no MTT e resultou em grande liberação de IL-2. No ensaio de Alamar Blue, esse grupo apresentou baixo percentual de proliferação celular, assim como o grupo que recebeu ciclo longo de polimerização em água aquecida e grupos submetidos à ativação química. Maior liberação de IL-6 foi observada nos grupos submetidos à ativação química e de IL-23 para o ciclo curto de polimerização em microondas. Maior expressão gênica de TGF ß1 ocorreu para o grupo que recebeu ciclo longo de polimerização em água aquecida seguido de 30 min de armazenamento em água. Maior expressão gênica de CASP9 ocorreu para o grupo ativado quimicamente sobre a bancada. Pode-se concluir que os métodos de polimerização por meio de energia de microondas (ciclos longo e curto) e por ativação química desencadearam uma resposta inflamatória mais intensa. Dentre os métodos de polimerização recomendados pelo fabricante, a polimerização em água aquecida apresentou resultados mais satisfatórios(AU)

The aim of this study was to evaluate the influence of different cycles and methods of white color acrylic resin (AR) for ocular prosthesis on the biocompatibility of human conjunctival cells and on the inflammatory response of rat subcutaneous tissue. For this, AR specimens were prepared in water bath (NRWB), by microwave energy (NRME), and chemically activated (ANR). For in vivo analysis, the inflammatory response of these 3 groups (n=20/group) was assessed in subcutaneous tissue of 20 Wistar rats at 7, 15, 30 and 60 days (d). Inflammatory cells were counted in the tissue adjacent to specimen after staining with hematoxylin and eosin. The immunohistochemical analysis was performed for the detection of IL-1ß, IL-6, TNFα, IL-17, and CCL20. For in vitro analysis, different cycles of polymerization for each method were evaluated, with a total of 11 groups (n=8/group). The degree of conversion (DC), MTT, ELISA, real-time RT-PCR and Annexin V and propidium iodide assays were performed. Quantitative data were submitted to Analysis of Variance and Tukey test with a 5% significance. Qualitative data were submitted to visual comparison. In in vivo analysis, there was a moderate inflammatory infiltrate for groups NRME and ANR, and a light infiltrate for the group NRWB after 7 d. The inflammatory infiltrate and the immunolabeling of tested targets decreased gradually during the 60 d. The group NRME exhibited the highest number of inflammatory cells, except for the group NRWB, which presented a higher number of eosinophils and lymphocytes after 15 d, and for the group ANR, where a higher number of macrophages and neutrophils were observed at 15 d and at 60 d, respectively. Groups NRWB and ANR showed higher IL-1ß immunolabeling after 7 d. The group ANR had the highest immunolabeling of IL-1ß (15 and 30 d), IL-6 (30 and 60 d), IL-17 (15 and 30 d), and TNF-α (7 d). Groups NRWB and NRME showed greater immunolabeling in the periods of 15 and 30 d, while the group NRME had also high results at 60 d. In in vitro analysis, all groups showed cell proliferation higher than 75%. The long cycle of polymerization using microwave energy resulted in lower DC and lower percentage of cell proliferation in the MTT assay and in large release of IL-2. In the Alamar Blue assay, this group had a low percentage of cell proliferation, as well as the group that received a long cycle of polymerization in water bath and groups submitted to chemical activation. A higher release of IL-6 was observed in groups submitted to chemical activation and of IL-23, for the short cycle of polymerization in microwave. Higher TGF ß1 gene expression occurred for the group that received long cycle of polymerization in water bath followed by 30 min of storage in water. Higher CASP 9 gene expression occurred for the chemically activated group on bench. It can be concluded that the polymerization by microwave energy (long and short cycles) and by chemical activation resulted in higher inflammatory response. Among methods recommended by the manufacturer, the water bath polymerization showed more satisfactory results(AU)

Discussion on the Key Aspects of Quality Control for Custom Ocular Prosthesis / 中国医疗器械杂志

Custom ocular prosthesis as a kind of product to make up the eye defects. It can not only improve patient's comfort adaptation and restore the normal structures but also let the patient regain confidence. However, it is in infant stage in our country for custom ocular prosthesis that the professional engineer is not enough, standards for the products are shortage. These factors together result in poor understanding of product management control and impede the development of ocular prostheses. This article gives the suggestions for quality management mainly focus on human resources, raw material, production and so on.

Experimental acrylonitrile butadiene styrene and polyamide evisceration implant: a rabbit clinical and histopathology study / Estudo clínico e histopatológico em coelhos eviscerados com utilização de implantes de poliamida e acrilonitrila butadieno estireno

The purpose of this study was to evaluate acrylonitrile butadiene styrene (ABS) and polyamide implants in rabbits submitted to evisceration at the macroscopic and microstructure level and to assess clinical response and histopathological changes as well. For the experimental study implants of 12mm diameter were prepared by rapid prototyping, weighed and the outer and inner surfaces evaluated macroscopically and by electron microscopy. In addition, a compression test was performed and ultrastructural damage was then determined. After evisceration of the left eyeball, nine New Zealand rabbits received ABS implants and nine others received polyamide implants. The animals were assessed daily for 15 days after surgery and every seven days until the end of the study (90 days). Histopathological evaluation was performed at 15, 45 and 90 days after surgery. The ABS implants weighed approximately 0.44g, while the polyamide ones weighed 0.61g. Scanning electron microscopy demonstrated that the ABS implants had regular-sized, equidistant micropores, while the polyamide ones showed micropores of various sizes. The force required to fracture the ABS implant was 14.39 ±0.60 Mpa, while for the polyamide one, it was 16.80 ±1.05 Mpa. Fifteen days after surgery, we observed centripetal tissue infiltration and scarce inflammatory infiltrate. Implants may be used in the filling of anophthalmic cavities, because they are inert, biocompatible and allow tissue integration.(AU)

Avaliou-se a macroscopia, a microestrutura, a resposta clínica e histopatológica de implantes de acrilonitrila butadieno estireno (ABS) e poliamida em coelhos submetidos à evisceração. Para o estudo experimental, os implantes foram elaborados por meio de prototipagem rápida, com 12mm de diâmetro, pesados e tiveram suas superfícies avaliadas macroscopicamente e por microscopia eletrônica de varredura. Adicionalmente, foi realizado ensaio de compressão para determinar a força necessária para fraturar os implantes. Após a evisceração do olho esquerdo, nove coelhos da raça Nova Zelândia receberam implantes de poliamida e nove outros receberam implantes de ABS. Os animais foram avaliados diariamente nos primeiros 15 dias após a cirurgia e a cada sete dias até o fim do período experimental (90 dias). Avaliação histopatológica foi realizada aos 15, 45 e 90 dias após a cirurgia. Os implantes de ABS pesaram 0,44g, e os de poliamida 0,61g. A microscopia eletrônica de varredura demonstrou que os implantes de ABS eram formados por microporos equidistantes, enquanto os de poliamida apresentavam microporos de vários tamanhos. A força necessária para fraturar os implantes de ABS foi de 14.39±0.60 Mpa, enquanto para os de poliamida foi de 16.80±1.05Mpa. Quinze dias após a cirurgia, foi observada infiltração fibrovascular centrípeta. Os implantes podem ser utilizados para correção de cavidades anoftálmicas por se mostrarem inertes, biocompatíveis e permitirem a infiltração tecidual.(AU)

An innovative impression technique for fabrication of a custom made ocular prosthesis.

Various impression and fitting techniques have been described in the past for restoring ocular defects. The present article describes a new direct impression technique for recording and rehabilitating ocular defects, by custom‑made ocular prosthesis. All the techniques described in the history, mainly concentrated in recording the tissue surface of the defect, which made it difficult to contour the palpebral surface resulting in the poor esthetics of the prosthesis. The present impression technique uses heavy bodied polyvinyl siloxane impression material, which facilitates accurate recording of the tissue surface and the palpebral surface of the defect, resulting in the fabrication of functionally and esthetically acceptable prosthesis.

A Simplified Approach for Customized Esthetic Acrylic Ocular Prosthesis: A Case Report.

Th e disfi gurement associated with loss of an eye can impact patient physically, socially and psychologically. Rehabilitation of this defect requires an individualized design of the technique for each patient. Replacing the missing part with a maxillofacial prosthesis will restore the defect, improve esthetics, and thereby improve the morale of the patient. Th e progress in the fi eld of maxillofacial prosthetic treatment has paved the way for a custom-made ocular prosthesis, which is superior compared with the traditional empirical method. Th is article describes a simplifi ed technique to fabricate an acrylic custom ocular prosthesis for an enucleated ocular socket. Th e procedure used here is simple and easy. Th is method has provided excellent results from patient esthetics, acceptance, and satisfaction point of view.

Análise in vitro da proliferação celular e produção de mediadores inflamatórios por células da conjuntiva estimuladas por materiais utilizados na confecção de próteses oculares / In vitro analysis of cell proliferation and the production of inflammatory mediators by conjunctiva cells stimulated by ocular prosthesis materials

A prótese ocular é utilizada para a reabilitação estética e funcional da ausência ocular. O conhecimento da sua biocompatibilidade é importante para a utilização sem reações danosas aos usuários. O objetivo neste estudo foi avaliar a citotoxicidade de materiais utilizados na confecção de próteses oculares, por meio da análise da proliferação celular e da produção de citocinas pró-inflamatórias e de proteínas de matriz extracelular por células da conjuntiva humana. Inicialmente, foi analisada a influência de diferentes períodos de formação e de exposição dos extratos de resina acrílica branca (N1), termopolimerizada em água aquecida, sobre culturas de células da conjuntiva. Foram confeccionados 24 corpos de prova em resina, sendo 12 para cada período de exposição de células da conjuntiva aos extratos da resina testada (24 e 72 horas). Após a formação dos extratos por 24, 48 e 72 horas de imersão em meio de cultura e, 24 horas em água seguido de 24 horas de imersão em meio, os ensaios propostos foram realizados (n=3). Em seguida, foi avaliado o efeito citotóxico de diferentes métodos de polimerização de resina acrílica N1 em células da conjuntiva. Foram confeccionados 9 corpos de prova em resina (n=3), termopolimerizados em água aquecida, por energia de microondas ou ativados quimicamente, utilizados para a formação dos extratos dessas resinas. Os extratos foram obtidos após 72 horas de imersão dos corpos de prova em meio de cultura e, então, expostos às células da conjuntiva por 72 horas para a realização dos ensaios propostos. Adicionalmente, foi analisada a influência da presença do pigmento acrílico na confecção da prótese de resina acrílica N1, termopolimerizada em água aquecida. Foram confeccionados 9 corpos de prova (n=3): resina N1, resina N1 + pigmento e, pigmento, utilizados para a formação dos extratos desses materiais. Os extratos formaram-se por 72 horas de imersão dos corpos de prova em meio de cultura e, então, foram expostos às células da...

Ocular prosthesis is a treatment option for esthetical and functional rehabilitation of ocular absence. The knowledge of ocular prosthesis material’s biocompatibility is important to ensure a safe use in patients. The aim of this study was to evaluate the cytotoxic effect of ocular prosthesis materials, through the analysis of the cell proliferation, and the production of proinflammatory cytokines and extracellular matrix proteins by a human conjunctival cell line. Initially, the influence of different preparation and exposition periods of eluates from heat-polymerized ocular prosthesis N1 color acrylic resin in human conjunctival cell line was evaluated. A total of 24 acrylic resin samples were manufactured and divided into 2 groups, according to the eluate exposition period to conjunctival cell line (24 and 72 hours). Eluates corresponding to 24, 48 and 72 hours of resin sample immersion in medium and, 24 hours of resin sample immersion in water followed by 24 hours of immersion in medium, were prepared (n=3) for the proposed tests. Then, the cytotoxic effect of different polymerization methods of ocular prosthesis N1 color acrylic resin was analyzed. A total of 9 acrylic resin samples were manufactured (n=3), according to the polymerization method: heat-polymerization in water bath, polymerization by microwave energy and auto-polymerization. Eluates corresponding to 72 hours of resin sample immersion in medium were prepared for proposed tests and exposed to conjunctival cell line for 72 hours. Additionally, the influence of pigment incorporation on the cytotoxicity of heat-polymerized ocular prosthesis N1 color acrylic resin was evaluated. A total of 9 samples were manufactured (n=3): N1 color acrylic resin without pigment incorporation, N1 color acrylic resin with pigment incorporation, and acrylic pigment. Eluates corresponding to 72 hours of sample immersion in medium were prepared and exposed to conjunctival cell line for 72 hours. The cytotoxic effect...

Afecciones de la conjuntiva en pacientes con prótesis ocular / Conjunctival diseases of patients with ocular prothesis

OBJETIVOS: determinar las afecciones conjuntivales en pacientes con prótesis ocular. MÉTODOS: estudio observacional descriptivo longitudinal prospectivo, conformado por 62 pacientes (65 cavidades anoftálmicas) quienes acudieron al Servicio de Oculoplastia del Instituto Cubano de Oftalmología "Ramón Pando Ferrer" en el período de mayo a diciembre de 2010. Se analizaron la edad, el sexo, las causas de la pérdida ocular, el ojo afectado, la afección conjuntival, el tipo de cavidad, el tiempo de uso protésico, el resultado microbiológico, el manejo higiénico y la respuesta al tratamiento. RESULTADOS: se presentaron 23 pacientes de 40 a 59 años (37,1 %), de los cuales el sexo masculino mostró el 66,1 %. El traumatismo reveló el 40,3 % y el ojo derecho el 50 %. El 33,8 % presentó conjuntivitis alérgica; las retracciones de la conjuntiva reportaron el 18,5 %. El 67,5 % correspondió a cavidades atípicas con un tiempo de más de 366 días en el uso de la prótesis ocular. El resultado microbiológico positivo en 55 cavidades fue de 84,6 %. Se aisló el Staphylococcus aureus en el 70,9 % y de ellos el 41,5 % se efectuó con manejo diario de la prótesis. La respuesta al tratamiento fue buena en el 76,4 %. CONCLUSIONES: las afecciones conjuntivales de los pacientes con prótesis ocular constituyen un problema de salud. Asimismo, la mayoría de las cavidades anoftálmicas son atípicas en adultos, con pérdida del globo ocular por traumatismo. La conjuntivitis alérgica y la retracción conjuntival son las afecciones más frecuentes en los pacientes con prótesis ocular de más de un año de uso, por la presencia de Staphylococcus aureus a consecuencia de mayor manipulación higiénico protésica, aunque en la mayoría de los casos existe buena respuesta al tratamiento.

OBJECTIVES: to determine the conjunctival diseases of patients with ocular prosthesis. METHODS: prospective, longitudinal, descriptive and observational study of 62 patients (65 anophthalmic cavities) who went to the Oculoplasty service of "Ramon Pando Ferrer" Cuban Institute of Ophthalmology from May to December 2010. Age, sex, causes of eye loss, affected eye, conjunctival disease, type of cavity, length of time of prosthesis use, microbiological result, hygienic handling and response to treatment were the analyzed variables. RESULTS: in the studied group, the 40-59 y age group accounted for 37,1 % of patients; males were predominant with 66,1 %. Traumatism was observed in 40,3 %, being the right eye the most affected in 50 % of cases. Likewise, 33,8 % presented with allergic conjunctivitis and 18,5 % had conjunctival retractions. Atypical cavities represented 67,5 % with over 366 days of using the ocular prosthesis. The positive microbiological result was found in 55 cavities for 84,6 %. Staphylococcus aureus was isolated in 70,9 % of cavities and 41,5 % with daily handling of the ocular prosthesis. The response to treatment was good in 76,4 % of patients. CONCLUSIONS: conjunctival diseases in patients with ocular prosthesis are a health problem. Similarly, most of the anophthalmic cavities are atypical in adults with loss of eyeball from traumatism. Allergic conjunctivitis and conjunctival retraction are the most frequent illnesses in the patients wearing ocular prosthesis for more than one year, due to Staphylococcus aureus presence resulting from frequent hygienic handling of the prosthesis. The majority of patients positively responded to treatment.

Avaliação do desenvolvimento experiencial de pacientes com prótese ocular: a focalização no atendimento clínico / Experiential development assessment of patients with prosthetic eye: focusing technique on psychotherapy / Evaluación del desarrollo experiencial de los pacientes con prótesis ocular: la focalización en la atención clínica

O presente estudo teve como objetivo verificar a eficácia da ferramenta de focalização utilizada em intervenção breve com pacientes em situação de prótese ocular. Foi realizado um estudo quasi-experimental de caso-controle com uma amostra de conveniência, composta por 10 participantes para o grupo experimental e oito para o controle. O Teste de Habilidade Experiencial (THE) foi utilizado para a coleta de dados em dois momentos em desenho de pré-teste/pós-teste. O grupo experimental vivenciou quatro sessões terapêuticas de focalização. O tamanho do efeito da diferença de crescimento da média do grupo experimental e do grupo controle foi pequeno-moderado (d = 0,38; p = 0,44). Implicações dos resultados para a prática da psicologia clínica são discutidas.

The present study aimed to verify the effectiveness of the focusing therapy applied in brief intervention with patients in context of ocular prosthesis. The design of case-control study included a convenience sample with 10 participants for the experimental group and eight participants for the control group. The data was collected by the Experiential Ability Test (EAT) on the pre-test and pos-test. The experimental group experienced four psychotherapy sessions guided by the focusing technique. The effect size of the difference in average growth in the experimental group and control group was small-moderate (d = 0.38, p = 0.44). Implications for the practice of clinical psychology are discussed.

El presente estudio tuvo como objetivo verificar la eficacia de la herramienta de focalización utilizado en breves intervenciones con pacientes con la prótesis ocular. Se realizó un estudio cuasi-experimental de casos y controles con una muestra compuesta por 10 participantes en el grupo experimental y ocho en el de control. El Test de la Habilidade Experiencial (THE) se utilizó para recopilar datos en dos puntos, pré-teste/pós-teste. El grupo experimental experimentaron cuatro sesiones terapéuticas de la focalización. El tamaño del efecto de la diferencia en el crecimiento promedio del grupo experimental y el grupo de control fue pequeña-moderada (d = 0,38, p = 0,44). Se discuten las implicaciones de los resultados para la práctica de la psicología clínica.

Effect of oral mucosa transplantation in the treatment of severe contracted conjunctival sac after ocular prosthesis implantation / 国际眼科杂志(Guoji Yanke Zazhi)

AlM: To observe the clinic effect of oral mucosa transplantation in the treatment of severe contracted conjunctival sac after ocular prosthesis implantation . METHODS: Thirty-three cases ( 33 eyes ) with globe disorders and severe contracted conjunctval sac were operated ocular prosthesis implantation firstly, and conjunctival sac plasty using oral mucosa after 6mo. RESULTS: Thirty - one cases were successful, no complications appeared. One case had primary ptosis and 1 case had recurrent conjunctival sac contracture. CONCLUSlON:lt is recognised that the methods of oral mucosa transplantation in severe contracted conjunctival sac after ocular prosthesis implantation are effective on those cases.

Comparison of Wettability for Ocular Prosthesis Depending on Different Kinds of Artificial Tear Eye Drops

PURPOSE: In this study we compared the surface wettability of ocular prosthesis and depositions depending on different types of artificial tear eye drops. METHODS: The artificial tear eye drops contain sodium hyaluronate (HA) 0.1%, 0.18%, 0.3%, carboxylmethylcellulose sodium (CMC), hydroxymethylcelluose + dextran (HMC), propylene glycol + polyethylene glycol (PG), polysorbate 80 (PS) povidone (Pov) were evaluated. Flat rectangular parallelepiped blocks consisting of polymethylmethacrylate (PMMA) or silicone materials were made. One artificial tear eye drop was applied on the surface of two different blocks of artificial eyes using a 23-gauge needle. Then, the static method contact angle was measured by using a contact angle goniometer. To measure the deposits, a petri dish was covered with 3 mL of artificial tear eye drops and dried for 48 hours at room temperature. Then, the light transmittance at the center of the petri dish was measured to investigate the amount of the residue. RESULTS: The contact angles of HA 0.1%, 0.18%, 0.3%, CMC, HMC, PG, PS and Pov on PMMA were 78.69degrees, 84.29degrees, 75.46degrees, 80.93degrees, 66.29degrees, 71.26degrees, 58.40degrees and 70.24degrees, respectively. The contact angles on silicone were 53.68degrees, 60.87degrees, 64.46degrees, 62.78degrees, 38.89degrees, 63.58degrees, 30.68degrees and 51.41degrees, respectively. The largest decrease in transparency was observed in the artificial tear eye drops containing HMC. CONCLUSIONS: The wettability and deposits on the surface of ocular prosthesis can vary based on the components and concentration of artificial tear eye drops. The results from this study should be considered when choosing the right artificial tear eye drops for improving dry eye symptoms in patients wearing ocular prostheses.

Comparison of Wettability for Ocular Prosthesis Depending on Different Kinds of Artificial Tear Eye Drops

PURPOSE: In this study we compared the surface wettability of ocular prosthesis and depositions depending on different types of artificial tear eye drops. METHODS: The artificial tear eye drops contain sodium hyaluronate (HA) 0.1%, 0.18%, 0.3%, carboxylmethylcellulose sodium (CMC), hydroxymethylcelluose + dextran (HMC), propylene glycol + polyethylene glycol (PG), polysorbate 80 (PS) povidone (Pov) were evaluated. Flat rectangular parallelepiped blocks consisting of polymethylmethacrylate (PMMA) or silicone materials were made. One artificial tear eye drop was applied on the surface of two different blocks of artificial eyes using a 23-gauge needle. Then, the static method contact angle was measured by using a contact angle goniometer. To measure the deposits, a petri dish was covered with 3 mL of artificial tear eye drops and dried for 48 hours at room temperature. Then, the light transmittance at the center of the petri dish was measured to investigate the amount of the residue. RESULTS: The contact angles of HA 0.1%, 0.18%, 0.3%, CMC, HMC, PG, PS and Pov on PMMA were 78.69degrees, 84.29degrees, 75.46degrees, 80.93degrees, 66.29degrees, 71.26degrees, 58.40degrees and 70.24degrees, respectively. The contact angles on silicone were 53.68degrees, 60.87degrees, 64.46degrees, 62.78degrees, 38.89degrees, 63.58degrees, 30.68degrees and 51.41degrees, respectively. The largest decrease in transparency was observed in the artificial tear eye drops containing HMC. CONCLUSIONS: The wettability and deposits on the surface of ocular prosthesis can vary based on the components and concentration of artificial tear eye drops. The results from this study should be considered when choosing the right artificial tear eye drops for improving dry eye symptoms in patients wearing ocular prostheses.

Custom Made Ocular Prosthesis at Optometry Clinic Universiti Kebangsaan Malaysia (UKM) / Jurnal Sains Kesihatan Malaysia

Patients who lost their eyes as results of accidents or diseases (e.g. retinoblastoma) usually underwent enucleation or evisceration. They were then fi tted with ocular prosthesis to prevent collapse of the globe and also for cosmetic effects. Custom made ocular prosthesis is almost unheard of in this country for most hospitals supply ready-made (stock) prosthesis. The cosmetic results of stock prosthesis are often unsatisfactory. Besides being uncomfortable, stock prosthesis may also induce allergic reaction that may lead to papillary conjunctivitis. The Optometry Clinic at UKM started its custom made prosthetic service in 2010. We described here two cases of patients who complained of discomfort with their old stock prosthesis and re-fi tted with custom made prosthesis. We also highlight the importance of proper hygiene and maintenance so that ocular prosthesis can be used for as long as possible. This article aims to create awareness among eye care practitioners and showcase the cosmetic benefi ts of custom made ocular prosthesis

A multidisciplinary approach for ocular rehabilitation following ophthalmomalacia in a paediatric patient.

The traumatic loss of an eye is not just the loss of an essential sense organ. It results in life-long agony of not being like others with two eyes, which can see and admire the nature’s beauty. As young patients are quite sensitive to peer pressure and for them, the greatest challenges are in the terms of identity and social acceptance, so, early rehabilitation is must in such patients. This article reports on the rehabilitation of a 13-year boy with custom ocular prosthesis for his traumatically injured left eye. The custom made ocular prosthesis fitted over the patient’s left eye with ophthalmomalacia, successfully restored the patient’s aesthetics and improved his social acceptance thereby, improving his quality of life.