Late-onset distal-apical intracorneal ring-segments keratopathy: an analysis of a large sample in a multicenter study.

PURPOSE: To review the prevalence and describe the characteristics, of cases with late-onset intracorneal ring segments (ICRS) keratopathy in a multicenter study. METHODS: A retrospective multicentric case-series study was performed in a specialized keratoconus service, from Buenos Aires, Argentina. An electronic clinical chart from patients with ICRS keratopathy between January 1999 and January 2019 was reviewed. We included cases with late-onset distal-apical ICRS keratopathy, which was defined as a persistent corneal lesion developed 12 months or later after implantation, located over, around, or closer to the ICRS. All the surgeries were performed by a manual corneal tunnel creation technique. Samples were taken to rule out infectious etiology. RESULTS: From 5217 eyes that underwent ICRS implantation, 13 cases (0.24%) were detected. The keratopathy onset was 72 ± 42.98 months (29-133) after ICRS implantation. Cultures were negative in all cases. An ICRS exchange was made for five cases in stage I and four in stage II. Four cases presented with partial ICRS extrusion in stage III. ICRS exchange was possible in two of them and a penetration keratoplasty was necessary for the rest. All cases remained stable 1 year after surgical procedures. CONCLUSIONS: A late-onset distal-apical ICRS keratopathy was detected with low prevalence (0.24%) in a large sample. It was classified into three stages according to its severity. Different treatments were selected for each stage, obtaining stable results 1 year after treatment.

Management of external ocular prosthesis by ocularists: results of an online survey conducted in Brazil and Spain.

PURPOSE: To analyse the ocularist's perspective on the management of the anophthalmic socket and external ocular prosthesis (EOP). METHODS: Ocularists from two countries were invited to participate in an online questionnaire. Data were collected on demographics, anophthalmic socket and EOP management (manufacturing, use, cleaning), complications, follow-up visits and multidisciplinary care. The frequency and proportions of the responses were statistically analysed. RESULTS: The questionnaire was addressed to 20 Brazilian and 17 Spanish ocularists, obtaining a response rate of 65% and 64.7%, respectively. 62.5% of respondents were men. The most common cause of anophthalmia in Brazil (69.2%) and Spain (36.4%) is an eye disease (chi square: p = 0.188). Polymethylmethacrylate (PMMA) is the most commonly used material in EOP manufacture (chi square: p = 0.448), and 70.8% reported using customized EOPs (chi square: p = 0.069). Deposits are frequently observed in both countries (chi square: p = 0.157). Changing the prosthesis is recommended after 5 to 10 years by Brazilian ocularists, and after less than 5 years of use by Spanish ocularists (81.8%) (chi square: p = 0.041). Annual follow-up is recommended by Spanish ocularists (45.5%), while semestral (38.5%) and case-dependent (38.5%) follow-up is recommended by Brazilian ocularists (chi square: p = 0.267). Daily cleaning is advocated by 61.5% of Brazilian ocularists and once a month by 45.5% of Spanish ocularists (chi square: p = 0.098), with 75% of ocularists from both countries not recommending EOP removal at night (Fisher´s exact test: p = 0.166). Good communication between ocularists and ophthalmologists was reported by 87.5% of our responders (chi square: p = 0.642). CONCLUSION: Although there are no unified protocols on the management of EOPs, Brazilian and Spanish ocularists follow similar guidelines. Differences between countries were the patients´ referral and the prosthesis´ useful life.

Analysis of microbial communities of ocular prostheses and anophthalmic sockets using 16S rRNA gene sequencing.

Ocular prostheses are liable to host microbial adhesion, which can favor conjunctival inflammation. Knowing the microbiota of the ocular prosthesis and anophthalmic socket is important for predicting infection-related pathogens. This study evaluated the microbiota of the prostheses and anophthalmic sockets of six individuals by 16S rRNA sequencing. The microbial abundance and diversity were analyzed using the Operational Taxonomic Units at the genus level. Forty-seven phyla, capturing 1,258 named genera, were recorded in the sample set. In both sites, the most frequent genera were Fusobacterium, Staphylococcus, Prevotella, and Streptococcus. The microbial abundance was higher for the anophthalmic socket than for the prosthesis. Alpha diversity showed no significant differences in bacterial richness or diversity between sites. Although the microbial abundance in the anophthalmic socket was higher, both sites had similar microbiota with high diversity and low dominance among the genera.

Cytotoxicity of cleaning agents for ocular prostheses.

BACKGROUND: Polymethylmethacrylate (PMMA) is the most used material for the manufacturing of eye prostheses. OBJECTIVES: To investigate the cytotoxicity of different cleaning agents for ocular prostheses on human conjunctival cells. MATERIAL AND METHODS: Six groups of specimens were created (saline, soap, 4% chlorhexidine, hydrogen peroxide, 1% triclosan, and citronella oil). Three specimens were made for each disinfectant at each disinfection period (1, 7, 15, 30, 60, and 90 days), totaling 108 specimens. Thus, the specimens were disinfected, with different disinfectants, for different periods of time. After each disinfection process, the specimens were washed with sterile distilled water. A human conjunctival cell line was grown on the acrylic resin specimens and then cytotoxicity tests (MTT and Neutral Red (NR)) were performed. A negative control (untreated cell cultures) and positive control (Tween 20) were created. Two-way analysis of variance (ANOVA) and Bonferroni test were performed (p < 0.05). RESULTS: For the MTT and NR tests, when there was a significant difference between the disinfectant and negative control, the disinfectant generated a significant reduction in cell proliferation most of the time. CONCLUSIONS: All reductions in cell proliferation caused by the disinfectants were clinically acceptable. All disinfectants tested in this study were found to be non-cytotoxic to human conjunctival cells.

Antibiofilm effect of cleaning agents for ocular prostheses.

Introduction: This study aimed to evaluate the antibiofilm effect of different agents (neutral soap, 4% chlorhexidine, Efferdent effervescent tablets, 1% triclosan, and citronella essential oil) used for ocular prosthesis cleaning. Material and Methods: Biofilms of S. aureus and S. epidermidis were formed on 60 ocular prosthesis acrylic resin specimens. The specimens were cleaned with the studied agents with different techniques. Microorganism counting was performed. Data were submitted to ANOVA and HSD Tukey-Kramer (p<.01). Results: When compared to the control group, all cleaning protocols promoted a reduction in growth of microorganisms. The 4% chlorhexidine, effervescent tablets, and 1% triclosan cleaning agents eliminated biofilm in all groups. Conclusion: Therefore, immersion in 4% chlorhexidine, effervescent tablets, and 1% triclosan could be the best protocols indicated for ocular prosthesis cleaning due to their ability to eliminate biofilm.

Evaluation of Different Polymerisation Methods of Ocular Prosthesis Acrylic Resins on Subcutaneous Tissue Inflammatory Response in Rats.

Objectives: This study aimed to evaluate the influence of different polymerisation methods of acrylic resin for ocular prostheses on the subcutaneous tissue inflammatory response of rats. Methods: The study was conducted at the Basic Sciences Department, Araçatuba Dental School, São Paulo State University (UNESP), Brazil, from 2016 to 2018. The samples were prepared by water bath (WB), microwave energy (MW) or autopolymerisation (AP) (n = 20 samples per group). The inflammatory response (cell count and immunohistochemical analysis of interleukin [IL]-1ß, IL-6, tumour necrosis factor [TNF]-α, IL-17 and macrophage inflammatory protein-3α) was analysed by the implantation of a sample from each group in the subcutaneous tissue of 20 Wistar rats and evaluated after seven, 15, 30 and 60 days. The quantitative and qualitative data were analysed using analysis of variance and Tukey tests (P <0.05) and visual comparison, respectively. Results: There was a moderate inflammatory infiltrate for the MW and AP groups and a light infiltrate for the WB group after seven days. The inflammatory infiltrate and the immunolabeling of tested targets decreased gradually during the 60-day period. The AP group had the highest immunolabeling of TNF-α (seven days), IL-1ß and IL-17 (at 15 and 30 days) and IL-6 (at 30 and 60 days). The WB and MW groups showed greater immunolabeling at 15 and 30 days, while the MW group also had high results at 60 days. Conclusion: Polymerisation by microwave energy and by chemical activation resulted in a higher inflammatory response.

Effect of magnification factor by Galilean loupes on working posture of dental students in simulated clinical procedures: associations between direct and observational measurements.

Objectives: To determine the effect of different levels of Galilean loupe magnification on working posture as measured by compliance with ergonomic posture positions, angular deviation from the neutral position of the neck, and muscle activation in the neck and upper back region during simulated clinical conditions. Methods: An experimental laboratory study was performed in which the dependent variables were compliance with ergonomic posture requirements while performing simulated restorative procedures in Restorative Dentistry, angular deviation from the neutral position of the neck, and muscle activation in the neck and upper back. The independent variable was the level of Galilean loupe magnification, which was tested at four levels (naked eye, 2.5× magnification, 3.0× magnification, and 3.5× magnification). The cavity preparations and Class I composite resin restorations were performed on artificial first molars on a mannequin in a dental chair. The Compliance Assessment of Dental Ergonomic Posture Requirements (CADEP) was used for the postural analysis; as was an analysis of the angular deviation from the neutral position of the neck and surface electromyography. Working posture was recorded on video over the course of the procedure. Participants were filmed from three different angles. The Compliance Assessment of Dental Ergonomic Posture Requirements (CADEP) assessed compliance with ergonomic posture requirements. A locally produced posture assessment software analyzed angular deviation. Surface electromyography bilaterally assessed activation of the sternocleidomastoid, descending trapezius and ascending trapezius muscles. Two-factor analysis of variance (ANOVA) and either Tukey's post-hoc test or the Games-Howell post-hoc test were performed (α = 0.05). Results: During the cavity preparations and restorations, the use of Galilean loupes at all magnifications positively influenced working posture as measured by participants' compliance with ergonomic posture positions (p < 0.01) and neck angulation (p < 0.01); the use of these loupes did not affect muscle activation in the regions evaluated (p > 0.05). Conclusion: The use of Galilean loupes had a positive effect on dental students' working posture during the restoration procedures performed.

Prótese intraescleral em um cão - evisceração e implantação / Intrascleral prosthesis in a dog - evisceration and implantation

Background: There is no hope of preserving vision at the terminal stage of glaucoma, and surgical treatment is indicated in thesecases. Among the various surgical techniques used, eye evisceration with implantation of an intrascleral prosthesis provide thebest cosmetic results. Even though eye evisceration with prosthesis implantation represents an excellent treatment option forterminal glaucoma, reports on the use of this technique in dogs are scarce in the current literature. The aim of this work is to reporta case of a dog with end-stage glaucoma subjected to eye evisceration surgery and implantation of an intrascleral prosthesis.Case: A 7-year-old bitch mixed breed with a history of glaucoma secondary to uveitis with no response to medical therapy wasreferred to the Ophthalmology service of the University Veterinary Hospital of Coimbra (HVUC), Portugal At the ophthalmicexamination, the glaucomatous left eye was buphthalmic, with congested episcleral blood vessels, mydriasis, and posterior luxation of the lens; there was no response to threat or obfuscation, no direct and consensual pupillary reflex, nor pupillary reflexesto chromatic light. The intraocular pressure (IOP) was 55 mmHg, and the Schirmers tear test (STT-1) result was 19 mm/min.Ophthalmoscopy revealed attenuated retinal blood vessels and a pale optic papilla with mild excavation. The right eye wasfunctional, with all parameters assessed on examination and by tests within the normal ranges for the species. An ultrasoundexamination of the left eye confirmed the presence of posterior luxation of the lens and buphthalmia in the absence of intraocularneoplasm. In view of the patients history and results of the clinical examinations, a surgical approach was indicated to treat theglaucomatous eye. The patients tutor requested a surgical procedure that...(AU)

Prótese intraescleral em um cão - evisceração e implantação / Intrascleral prosthesis in a dog - evisceration and implantation

Background: There is no hope of preserving vision at the terminal stage of glaucoma, and surgical treatment is indicated in thesecases. Among the various surgical techniques used, eye evisceration with implantation of an intrascleral prosthesis provide thebest cosmetic results. Even though eye evisceration with prosthesis implantation represents an excellent treatment option forterminal glaucoma, reports on the use of this technique in dogs are scarce in the current literature. The aim of this work is to reporta case of a dog with end-stage glaucoma subjected to eye evisceration surgery and implantation of an intrascleral prosthesis.Case: A 7-year-old bitch mixed breed with a history of glaucoma secondary to uveitis with no response to medical therapy wasreferred to the Ophthalmology service of the University Veterinary Hospital of Coimbra (HVUC), Portugal At the ophthalmicexamination, the glaucomatous left eye was buphthalmic, with congested episcleral blood vessels, mydriasis, and posterior luxation of the lens; there was no response to threat or obfuscation, no direct and consensual pupillary reflex, nor pupillary reflexesto chromatic light. The intraocular pressure (IOP) was 55 mmHg, and the Schirmer’s tear test (STT-1) result was 19 mm/min.Ophthalmoscopy revealed attenuated retinal blood vessels and a pale optic papilla with mild excavation. The right eye wasfunctional, with all parameters assessed on examination and by tests within the normal ranges for the species. An ultrasoundexamination of the left eye confirmed the presence of posterior luxation of the lens and buphthalmia in the absence of intraocularneoplasm. In view of the patient’s history and results of the clinical examinations, a surgical approach was indicated to treat theglaucomatous eye. The patient’s tutor requested a surgical procedure that...

Amplitude of movements with conical or spherical implants in anophthalmic socket.

PURPOSE: To evaluate the amplitude of movement in anophthalmic sockets reconstructed with conical or spherical orbital implants with and without an external ocular prosthesis (EOP), and whether the fornix depth could play a role. METHODS: Prospective observational study involving unilateral anophthalmic sockets evaluated the amplitude of movement with conical (20 subjects) or spherical (16) non-porous orbital implants, with and without an EOP, having the contralateral eye as the control group. Standardized photographs were obtained in the four gaze directions and measurements were performed using the Image J software. The upper and lower fornix depths were measured using rulers. RESULTS: Compared to the contralateral eye, the median movement amplitude without EOP was smaller with conical implants in supraduction (-0.88 mm, p=0.008), abduction (-2.26 mm, p<0.001) and adduction (-0.91 mm, p=0.008). Spherical implants had reduced movement only in abduction (-2.63 mm, p<0.001). Conical and spherical implants had similar amplitudes of movement in all versions, and were always smaller compared to the control. The median movement amplitude with the EOP was -3.05 mm (p=0.001) than without the EOP in abduction and -2.07 mm (p=0.020) in adduction, regardless of implant format. The fornix depth did not affect the orbital implants or EOP movement amplitude's median. CONCLUSION: Conical and spherical implants provide similar amplitude of movement and fornix depth did not have an influence on it. The amplitude of movement was significantly limited compared to the contralateral eye and was even more reduced if the EOP was in place with conical or spherical implant formats.

Características clínicas y evolutivas de pacientes rehabilitados con prótesis oculares / Clinical and evolutive characteristics of patients rehabilitated with ocular prosthesis

Introducción: La prótesis ocular es un medio artificial con fines funcional y estético, que posibilita la rehabilitación física, psíquica y social de pacientes con defectos en los ojos. Objetivo: Describir la evolución de los pacientes con prótesis ocular según signos de infección en las cavidades oculares rehabilitadas, factores de riesgos asociados, así como modificaciones en la forma de la cavidad y/o en la prótesis ocular. Métodos: Se realizó un estudio observacional, longitudinal y prospectivo de 74 pacientes aquejados por defectos oculares, que recibieron tratamiento protésico en el período de 2018 a 2019 en la Clínica de Rehabilitación Bucomaxilofacial de Santiago de Cuba, los cuales fueron evaluados a través de una encuesta y un examen clínico en tres momentos durante un año de evolución. Para establecer la asociación entre variables, se emplearon la prueba de la Χ2 de Pearson y la exacta de Fisher de acuerdo con el cumplimiento de supuestos. Resultados: De los 222 exámenes efectuados a las cavidades oculares rehabilitadas, 31 revelaron la presencia de secreciones en 23 pacientes, con recurrencia en 8 de ellos; dicho signo clínico se manifestó de manera similar a la hipercoloración de la conjuntiva en cuanto al momento del hallazgo y al grupo etario afectado, con mayores porcentajes al año de evolución y una incidencia superior en los pacientes de 60 y más años de edad. Asimismo, se constató una asociación estadísticamente significativa de las variables higiene diaria de la cavidad y de la prótesis con la existencia de secreciones, para un intervalo de confianza de 95 %. Conclusiones: Se demostró la ventaja del aseo semanal de la cavidad ocular y de la prótesis en sus portadores, pues con ello se disminuye la frecuencia de los signos inflamatorios e infecciosos de la mucosa, lo que debe observarse con mayor rigurosidad en los ancianos, quienes resultan ser los más afectados.

Introduction: Ocular prosthesis is an artificial means with functional and cosmetic ends that facilitates the physical, psychic and social rehabilitation of patients with eyes defects. Objective: To describe the evolution of patients with ocular prosthesis according to infection signs in the rehabilitated ocular cavities, associated risk factors, as well as modifications in the form of the cavity and/or in the ocular prosthesis Methods: An observational, longitudinal and prospective study of 74 patients suffering from eye defects that received prosthetist treatment from 2018 to 2019 in the oral maxillofacial Rehabilitation Clinic was carried out in Santiago de Cuba, who were evaluated through a survey and a clinical exam in three moments during a year of evolution. To establish the association between variables, the Pearson chi-square and Fisher exact tests were used with the fulfillment of suppositions. Results: Of the 222 exams made to the rehabilitated ocular cavities, 31 revealed the presence of secretions in 23 patients, with recurrence in 8 of them; this clinical sign became evident in a similar way to the hypercoloring of the conjunctiva as for the moment of the finding and the age group affected, with higher percentages at the year of evolution and a higher incidence in the patients of 60 years and over. Also, an association statistically significant of the daily hygiene of the cavity and prosthesis variables with the existence of secretions was verified, for a confidence interval of 95 %. Conclusions: The advantage of the ocular cavity and prosthesis weekly personal cleanliness was demonstrated, because with it the frequency of the inflammatory and infectious signs of the mucous is reduced, what should be strictly observed in elderly, who are the most affected.

Effect of processing methods on the cytotoxicity of methyl methacrylate-based ocular prostheses: An in vitro study.

The study evaluated the influence of cycles and methods of an ocular prosthesis resin on cytotoxicity toward human conjunctival cells. Resins were polymerized by water bath (WB, 74 °C or 100 °C for 30 min to 9 h), microwave (MW, 1200 W, 3 to 14 min and 30 s at 0 to 720 W), or autopolymerization (AP, room temperature for 20 min ± 60 °C for 30 min). Degree of conversion (DC), cytotoxicity, level of inflammatory mediators, gene expression of different markers, and apoptosis were evaluated. Data were submitted to ANOVA and Tukey test (p < 0.05). WB with longer processing time at higher temperature had highest DC (85.6%) and higher TGF ß1-gene expression (1.39); long cycle low power MW showed lowest DC (69.6%), lower cell proliferation (85.4%, MTT), and large IL-2 release (39,297 ng/mL). AP with additional processing time showed lower cell proliferation (75.3%, Alamar Blue), and AP polymerized at room temperature showed higher CASP 9-gene expression (1.21). AP methods showed higher IL-6 release (>277 pg/mL). Short cycle medium power MW had higher IL-23 release (534.2 pg/mL). MW (long and short cycles) and AP polymerizations have triggered a more intense inflammatory response. Among methods recommended by the manufacturer, WB showed high DC and less cytotoxicity.

Reabilitação com prótese oculopalpebral após exenteração de órbita: relato de caso / Rehabilitation with oculopalpebral prosthesis after orbit exenteration: a case report / Rehabilitación com prótesis oculopalpebral después de la exenteración de la órbita: reporte de un caso

Introdução: A ressecção cirúrgica de tumores em região de cabeça e pescoço é um tratamento eficaz, mas que implica em significativa desfiguração facial dependendo da localização da lesão. Aqueles pacientes considerados curados precisam ser reabilitados estética e funcionalmente para que possam ser reintegrados às funções sociais. A prótese maxilofacial é um artefato de baixo custo, que pode resolver essa necessidade. Relato de caso: Esse artigo relata o caso de uma paciente de 19 anos submetida à exenteração de órbita para tratamento de Tumor Fibroso Solitário Retrorbitário que, após a cirurgia e radioterapia adjuvante, foi reabilitada por meio de prótese óculopalpebral em silicone. Conclusão: O caso foi considerado um sucesso e ressalta a importância do cirurgião dentista na equipe oncológica e o positivo impacto psicológico e social da reabilitação(AU)

Introduction: Surgical resection of head and neck tumors is an effective treatment, but it implies significant facial disfigurement depending on the location of the lesion. Those patients considered cured need to be rehabilitated aesthetically and functionally so that they can be reintegrated into social functions. The maxillofacial prosthesis is an artifact of low cost, which can solve thisneed. Case Report: This article reports the case of a 19-year-old patient who underwent orbit exanteration for the treatment of Solitary Retrorbital Fibrous Tumor, which, after surgery and adjuvant radiotherapy, was rehabilitated using an oculopebral prosthesis made of silicone. Conclusion: The case was considered a success and highlights the importance of the dental surgeon in the oncology team and the positive psychological and social impact of rehabilitation(AU)

Introducción: La resección quirúrgica de los tumores de cabeza y cuello es un tratamiento eficaz, pero implica una desfiguración facial significativa según la ubicación de la lesión. Aquellos pacientes considerados curados necesitan ser rehabilitados estética y funcionalmente para que puedan reintegrarse a las funciones sociales. La prótesis maxilofacial es un artefacto de bajo costo que puede resolver esta necesidad. Reporte del caso: Este artículo informa el caso de una paciente de 19 años que se sometió a una exenteración de órbita para el tratamiento del tumor fibroso retrorbital solitario, que, después de la cirugía y la radioterapia adyuvante, fue rehabilitada con una prótesis oculopalpebral de silicona. Conclusión: El caso se consideró un éxito y destaca la importancia del cirujano dental en el equipo de oncología y el impacto psicológico y social positivo de la rehabilitación(AU)

The Impact of an Ocular Prosthesis on the Quality of Life, Perceived Stress, and Clinical Adaptation of Anophthalmic Patients: A Clinical and Longitudinal Trial.

PURPOSE: This prospective study evaluated and correlated the impact of ocular prostheses on quality of life and stress with socioeconomic level and clinical characteristics. The clinical difficulties and perceptions of patients after ocular rehabilitation were evaluated. MATERIALS AND METHODS: Anophthalmic patients (at least 18 years of age) who were not users of ocular prostheses were recruited. The Medical Outcomes Short-Form Health Survey (SF-36) and Perceived Stress Scale (PSS-10) questionnaires were administered before and after 3 and 6 months of prosthesis installation. Clinical characteristics, difficulties, and perceptions were evaluated by quantitative and descriptive analysis (7 days, 3 months, 6 months). Data were analyzed by the Friedman test and Pearson Correlation test (α = 0.05). RESULTS: The final sample consisted of 26 patients. Quality of life showed improvement in the "Bodily Pain" and "General Health" domains. Wearing the prosthesis did not influence perceived stress. The clinical evaluation showed clinical discharge over 6 months and presence of pain only at 7 days. A weak correlation occurred between sociodemographic characteristics and the categories "Role-Physical" (r = 0.423) and "General Health" (r = 0.494); cause of anophthalmia and "Role-Physical" (r = -0.471); and type of surgery and "General Health" (r = -0.432). CONCLUSIONS: According to the results of this study, the provision of ocular prostheses showed positive influence in 2 domains of quality of life and weak correlations with socioeconomic level, type of surgery, and cause of loss. Ocular rehabilitation did not influence stress. The use and care of the prostheses did not affect tissue inflammation, but the discharge was continuous.

Rehabilitación protésica individualizada en un defecto ocular de origen traumático. Reporte de caso / Individualized prosthetic rehabilitation in an ocular defect of traumatic origin. Case report

El trauma ocular constituye la causa de pérdida ocular más frecuente a nivel mundial y puede presentarse en cualquier etapa de vida, con mayor incidencia en la niñez. El manejo puede ser quirúrgico, quirúrgico-protésico o protésico. A continuación, se presenta un caso clínico que describe la rehabilitación protésica individualizada posterior a una evisceración en una lesión ocular unilateral traumática de hace aproximadamente 56 años, que presenta ptosis del párpado superior, colapso y atrofia muscular debido a la falta de función. Se describe la técnica de confección de los conformadores oculares para corregir la ptosis del párpado superior y lograr la expansión gradual de la cavidad, así como la confección de la prótesis ocular individualizada, con el objetivo de alcanzar los requerimientos funcionales y estéticos esperados. (AU)

Ocular trauma is the most frequent cause of eye loss worldwide. It can occur at any stage of life, with a higher incidence in childhood. Management can be surgical, surgical - prosthetic or prosthetic. We describe individualized prosthetic rehabilitation in a clinical case of upper eyelid ptosis, collapse and muscle atrophy due to lack of function following evisceration in a traumatic unilateral ocular injury approximately 56 years previously. We describe the technique for making ocular shapers to correct ptosis of the upper eyelid and achieve gradual expansion of the cavity, as well as the preparation of an ocular prosthesis to fulfill the expected functional and esthetic requirements. (AU)

In vitro evaluation of the effect of different disinfectants on the biofilm of Staphylococcus epidermidis and Staphylococcus aureus formed on acrylic ocular prostheses.

The aim of this study was to evaluate the effect of disinfectants on the biofilm of Staphylococcus aureus and Staphylococcus epidermidis formed on the acrylic surface of ocular prostheses. In this study, 396 acrylic specimens were manufactured (50% for Staphylococcus epidermidis, and 50% for Staphylococcus aureus). For each bacterium, 66 specimens were subjected to biofilm formation on their surfaces for 24 hours, 66 specimens were subjected to biofilm formation on their surfaces for 48 hours, and 66 specimens were subjected to biofilm formation on their surfaces for 72 hours. Then, they were divided into groups according to disinfection method (n = 6): sterile distilled water for 10, 15, 30 min, and 6 hours (control); soap for 30 min (NES30); Opti-Free for 30 min (OPF30) and 6 h (OPF6); Efferdent for 15 min (EFF15); and 0.5%, 2%, and 4% chlorhexidine for 10 min (0.5% CHX10, 2% CHX10, and 4% CHX10). After the treatments, the specimens were vortexed to release the biofilm and the counting of bacterial colonies was performed (CFU/mL). Three-way ANOVA and the Tukey-Kramer HSD test were used (α = 0.05). For Staphylococcus epidermidis, there was no significant difference between NES30, OPF30, and OPF6 with their respective control groups; nor between NES30, OPF30, and OPF6 themselves, regardless of the biofilm development period (P >0.05). For Staphylococcus aureus, there was no significant difference between NES30 and OPF30 with their control group; nor between NES30 and OPF30 themselves, regardless of the biofilm development period (P >0.05). For Staphylococcus aureus, OPF6 showed a significant reduction in the number of CFU/mL when compared with its control group, NES30, and OPF30, regardless of the biofilm development period (P <0.05). For both bacteria, 0.5% CHX10, 2% CHX10,4% CHX10, and EFF15 showed a significant reduction in the number of CFU/mL when compared with their control groups, NES30, OPF30, and OPF6, regardless of the biofilm development period (P <0.05). Therefore, EFF15 and CHX (0.5%, 2% and 4%) were effective in reducing Staphylococcus epidermidis and Staphylococcus aureus on acrylic surfaces. NES30 and OPF (30 and 6) are not recommended.

Tratamento reabilitador de deformidade ocular: relato de caso / Treatment of eye deformity: a case report

O olho, responsável por um dos nossos cinco sentidos, é considerado a janela das nossas vidas, por onde observamos as paisagens, vivenciamos experiências e registramos as imagens. A ausência parcial ou total desse orgão pode acarretar problemas funcionais, estéticos, pessoais e sociais ao seu portador. Por se encontar na região da face, aréa considerada nobre para a identidade do indivíduo, a deformidade ocular acaba sendo muito constrangedora ao mesmo, dificultando sua interação com o próximo e afetando diretamente seus aspectos psicológicos. O objetivo deste trabalho é apresentar um relato de caso clínico de reabilitação com prótese ocular. Dessa forma foi realizado a seguinte sequência clínica: Moldagem da cavidade ocular, prova e ajustes da esclera artificial, pintura da íris artificial e instalação da prótese finalizada. O tratamento reabilitador possibilitou a restauração da harmonia facial e, com isso, devolveu a autoestima perdida do indivíduo, reinserindo-o à sociedade(AU)

The eye, responsible for one of our five senses, is considered the window of our lives, through which we observe the landscapes, experience and record the images. The partial or total absence of this organ can cause functional, aesthetic, personal and social problems to its bearer. Because it is found in the region of the face, which is considered noble for the identity of the individual, the eye deformity ends up being very embarrassing to it, making it difficult to interact with others and directly affecting their psychological aspects. The aim of this paper is to present a case report of rehabilitation with ocular prosthesis. Thus, the following clinical sequence was performed: Ocular cavity molding, testing and adjustments of the artificial sclera, painting of the artificial iris and installation of the finished prosthesis. The rehabilitative treatment enabled the restoration of facial harmony and, thus, returned the lost selfesteem of the individual, reinserting him to society(AU)

18F-NaF Uptake in Ocular Prosthesis (Implant).

Ocular prosthesis is used as a replacement in the orbit following enucleation or evisceration of the eye. Polymethyl methacrylate (PMMA), hydroxyapatite (HA) and porous polyethylene (PP) are some examples of the materials used in ocular prosthesis. We present a case of an 82-year-old man with prostate cancer who underwent F-NaF PET/CT imaging for evaluation of bone metastases and was incidentally found to have increased NaF uptake in the ocular prosthesis.

Uso de resina acrílica no preenchimento de cavidade orbital após exenteração em um cão com hemangiossarcoma conjuntival / Use of acrylic resin to fill the orbital cavity after exenteration in a dog with conjunctival hemangiosarcoma

Background: The hemangiossarcoma (HSA) is a malignant tumor originated from the alterations of vascular endothelialcells. As it has an aggressive behavior, it is indicated, as initial treatment, wide surgical excision, such as the exenteration, which results in the surgical removal of the ocular bulb and adjacent tissues. The referred technique has as a resulta concave orbit and aesthetically unacceptable. Therefore, various materials, used as orbital implants, have been studiedand used in several species. Thus, it was aimed to report the use of the polymethylmethacrylate (PMMA) to fill the orbitalcavity after exenteration in a dog with conjunctival HSA.Case: A 10-year-old male Pitbull dog was assisted, with a clinical history of growth of a reddish tissue in the left eye, causingconstant hemorrhage, with an evolution of two months. At ophthalmic examination of the left eye, in the temporal bulbar conjunctive was found a reddish neoformation, with an irregular surface, measuring approximately 4 x 2 x 2 cm. The biopsy andaspiration cytology of the neoformation, revealed cells that inferred that they were those of conjunctival HSA. The hemogramrevealed normocytic anemia; the biochemical profile was with the standards of normality and no metastasis were found in theultrasonography and X-ray. The treatment of choice was the exenteration. Initially, the palpebral borders were approximatedusing continuous simple suture wit monofilament nylon thread. An incision was made in the skin, along the orbital rim andthen was performed a rhombus dissection of the conjunctive and all the extraocular muscles. Next, the eye globe, together withthe neoplasia, soft tissues of the orbital cavity and third eyelid were removed. The PMMA was obtained from a mixture of thepowder (polymer) and of the liquid (monomer) in the ratio of 1:1 in a sterile recipient, in...(AU)

Can Nonthermal Plasma Improve the Adhesion between Acrylic Resin for Ocular Prostheses and Silicone-Based Relining Material?

PURPOSE: To investigate the influence of nonthermal plasma (NTP) treatment on the tensile bond strength between heat-polymerized acrylic resin for ocular prostheses and silicone reliner, with and without the use of an adhesive primer. MATERIALS AND METHODS: One-hundred and sixty-four acrylic resin specimens were fabricated and randomly distributed into four groups according to the type of surface treatment: Sofreliner Primer, NTP, Sofreliner Primer + NTP, and NTP + Sofreliner Primer. Two specimens interposed with relining material (Sofreliner) formed one test sample to perform the tensile bond strength tests, before (initial) and after storage (final) in saline solution (37°C, 90 days, n = 10). Surface characterization was performed by scanning electron microscopy (SEM) and energy dispersive spectroscopy (EDS). The failure type was classified as cohesive, adhesive, or mixed. The data were analyzed statistically using the two-way ANOVA and Tukey test, as well as the chi-squared test (α = 0.05), Bonferroni correction (α = 0.005), and Spearman correlation coefficient (α = 0.05). RESULTS: The SEM and EDS analyses showed the presence of a thin, homogenous organic film in the groups treated with NTP. The NTP + Sofreliner Primer group presented the largest bond strength mean values in the initial period (p < 0.05). Sofreliner Primer and NTP + Sofreliner Primer groups presented the first and second largest tensile bond strength mean values in the final period (p < 0.05), respectively. NTP + Sofreliner Primer group also had the largest number of cohesive (70%, initial) and mixed (90%, final) failures. CONCLUSIONS: The NTP treatment performed before the primer application enhanced the bond between the acrylic resin ocular prosthesis and the Sofreliner silicone-based reliner, even after 90 days of immersion in saline solution.