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With a special application technique developed by Prof. Dr. Ümit Beden and his team, Istanbul Prosthetic Eye Center carries out personal prosthetic eye production with the approval of several ophthalmologists and eye clinics in domestic and at abroad.

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What is a prosthetic eye?

These are the prostheses applied for cosmetic purposes to the patients who do not have an eye congenitally, whose eye was removed surgically, who has deformity in their eye or who lost their eye for any reason.

These are the materials applied in case the eye is lost due to an accident, congenital causes, diseases or cancer or in case for a deformity in the eye compared to the original eye.

Maintenance of prosthetic eye protects the health of orbit, as well as prolongs the life of the eye prosthesis used and helps preserving the quality of the eye prosthesis.

Although some people prefer removing their eye prosthesis at nights, it is ideal that the prosthesis is used all the time during day and night. Proteins and various materials are stored by time on the surface of the eye prosthesis used. Therefore, the prosthesis should be removed periodically and cleaned with ultrasonic methods.

It is consisted for five stages.

  • Surgical Preparation
  • Molding Stage
  • Temporary Prosthesis Use and Rules
  • Coloring Period
  • Delivery of Permanent Prosthetic Eye

Socket of the person, whom the movable prosthesis will be applied for, is examined. Then, the size is measured and the mold is taken with silicon. A wax mold is created from the size measured. It is tested on the patient, a decision is taken on the final version, and then it is taken to acrylic mold. In this way, the prosthesis perfectly fits the socket of the patient, and moves closely with the other eye.

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Prosthetic Eye Production and Surgeries

First, it is required to prepare the socket to the prosthesis. In order to do this, a ball shaped implant is inserted replacing the eye while the eye is removed. A few weeks later, the mold of socket is taken for the eye prosthesis and the prosthesis is prepared. After that, the prosthetic eye is placed to the socket and final touches are made according to the position of the prosthesis. The prosthetic eye is prepared within a few days after the mold of socket is taken. After this stage, it might be required to set some prosthesis application appointments until the prosthesis is finalized.

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Frequently Asked Questions

First, it is required to prepare the socket to the prosthesis. In order to do this, a ball shaped implant is inserted replacing the eye while the eye is removed. A few weeks later, the mold of socket is taken for the eye prosthesis and the prosthesis is prepared. After that, the prosthetic eye is placed to the socket and final touches are made according to the position of the prosthesis.

The prosthetic eye is prepared within a few days after the mold of socket is taken. After this stage, it might be required to set some prosthesis application appointments until the prosthesis is finalized.

In some cases, the eye prostheses are applied without removing the eye. For the phthisic (smaller than normal) eyes, the prosthesis may be placed on the person’s eye. The ophthalmologist must decide whether this application is suitable or not.

It is particularly required to place a prosthesis is the eye is not congenitally available or the eye is very small (there is a vision loss). As the eye volume is deficient in these patients, the development of facial bones might be deficient. Therefore, prosthesis must be placed to these patients without loss of time, and it should be ensured that a symmetrical face is developed by replacing these prostheses with bigger ones regularly.

It might be required to remove the eyes for various reasons. Reasons can be listed as follows: Accidents (chemical, thermal, mechanical), congenital disorders, infections, cancers and painful eye pressure cases where the eye has lost its vision function.

There is no need for a surgery to place the prosthesis, but first a ball shaped implant must be placed giving volume and movement to the socket. A ball shaped implant is placed replacing the eye in order to compensate the volume loss during the removal of eye. This ball shaped implant is covered with tissue and permanently remains in its place. Eye prosthesis can be removed and placed back to the socket during the subsequent process (2-4 weeks). The patient does not feel any pain while placing and removing the prosthesis, but they may feel some tension on their eyelids.

Although the surgical techniques may vary, there are essentially three different surgical methods.

  1. Evisceration: In this operation, all the intraocular contents are removed while preserving the remaining scleral shell. The scleral shell is closed by placing a sphere in order to give volume to this cavity. UTSE operation is an evisceration method where the cornea is preserved.
  2. Enucleation: In this operation, the eyeball is completely removed together with the scleral shell. The eye muscles and the orbital fat tissue around the eye are preserved. During this operation, eye muscles are stitched on the ball shaped implant, which replaces the eye, thus the eyeball can move.
  3. Exenteration: In this operation, the eyeball, eyelids and all the other tissues around the eye (all the tissues between the eyebrow and the cheek) are removed. This operation is mostly applied for dangerous tumors around the eye.
  4. FCVB (Intraocular Balloon Application): This procedure is used for preserving the shape of the eye, if it has not become smaller yet, and for preventing the removal of the eye.

Removal of eye causes a volume loss in the socket. Aim of the ball shaped implant placed here is to compensate this volume loss and to prepare the socket for a good prosthesis movement.

Ball shaped implant placed is very important for the prosthesis to be used. These ball shaped implants can be produced from silicon, plastic, acrylic or any other material that can become integrated to the body. Harmony of the ball shaped implant with the surrounding tissues and its ability to move would directly affect the appearance and movements of the prosthesis to be applied on it. In this stage, using good quality ball shaped implants and suitable surgical techniques is vital for the cosmetic result to be obtained with the prosthesis.

Today, mostly the porous type ball shaped implants with a biointegration feature allowing the development of vein and tissue are preferred. The most important advantages of such ball shaped implants are that they do not fall down towards the cheek by the years as they are light and that they provide a better prosthesis movement as they allow veins and tissues to go towards inside.

Eye prosthesis are made from acrylic. This material resembles glass, but it is relatively lighter and is unbreakable.

It is better to produce the prosthesis according to the eye of the person. This is because both the prosthesis color is processed according to the color of the other eye and the shape of prosthesis is prepared according to the structure of the eyelids by taking the mold of person’s socket. In this case, the appearance and movements of the prosthesis will be more compatible with the other eye and will not cause pain and discomfort. Additionally, the structure and material of the personal prostheses are safer in terms of eye gunk and allergy formation, are more resistant to breakage and have a life than ready-to-use prostheses.

Prostheses that do not fit the socket and the appearance of the other eye should not be preferred as they do not look good cosmetically. Placing larger prostheses in the socket can cause a tension on the eyelids and especially a deformation of the lower eyelid (ectropion). And placing small prostheses may cause shrinkage in the socket by time and may result in the inability to place the appropriate prosthesis. Small prostheses may also cause falling of the upper eyelid, as well as to cosmetic problems.

The movements of the prosthesis are ideally close to those of the other eye. There are many factors affecting this. These factors include the condition of the eye muscles, the properties of the surgery where the eye is removed, the properties of the ball shaped implant in place of the eye, the condition of the socket, whether a peg (screw) is attached to the ball shaped implant, and whether the prosthesis used is made for the person. It is possible to provide a good prosthesis movement in patients whose eye muscles work well and the ball shaped implant replacing the eye moves well, the socket is suitable, peg can be attached to the ball shaped implant and a personal prosthesis is prepared.

In cases where body-integrated ball shaped implants have been used, approximately 6 months after the first surgery, peg (screw) can be attached to this ball shaped implant after demonstrating that the vascularization of the ball shaped implant is good. Then, the eye prosthesis is attached to this screw. Thanks to peg, the movements of the ball shaped implant are directly transmitted to the prosthesis, so the prosthesis movements will be better. But nowadays, this method is not preferred by ophthalmologists as it causes many problems.

In order to attach a peg, the ball shaped implant placed in the socket must be of the type that allows vein and tissue progress (hydroxyapatite, bioceramic, porous polyethylene). It is not possible to attach pegs on silicone or acrylic ball shaped implants.

Although attaching a peg provides a good cosmetic result, it has the disadvantages such as a second surgery and costs. In addition to this, problems such as infection, opening of the ball shaped implant and continuous eye gunk are possible after attaching the peg. Therefore, the decision for attaching the peg should be taken jointly by the doctor and the patient.

It is not necessary to remove the prosthesis from the eye on a daily basis. On the contrary, even removing the prosthesis for a while may cause shrinkage in the socket. Therefore, the prosthesis should never be removed from the eye, including at night.

Eye prostheses can be easily removed and placed by many people. During this procedure, however, it is important that it is removed and placed as recommended by your doctor and that the eyelids are not forced.

Wash your hands with soap that does not contain oil, lotion or perfume, rinse with plenty of water, then dry them with a towel that does not leave lint on your hands. Step in front of a mirror. Look into the mirror by lowering your head forward. To place the prosthesis, first pull the lower eyelid down with one hand, and place the prosthesis properly into the socket with the other hand so that the upper part is placed first. Make sure that the upper part of your prosthesis is in place and leave your lower eyelid slowly.

Wash your hands with soap that does not contain oil, lotion or perfume, rinse with plenty of water, then dry them with a towel that does not leave lint on your hands. Step in front of a mirror. Look into the mirror by lowering your head forward. Gently pull your lower eyelid down. Slightly push your index finger towards the bottom of the prosthesis, allowing the lower edge of your prosthesis to slide down. Your prosthesis will come out easily.

  • You may experience stinging and discomfort feeling the first time you place your prosthesis. These problems will go away within a few hours to a few days
  • In cases where the prosthesis is removed, it is necessary to comply with the hygiene rules when placing the prosthesis.
  • Alcohol or chemical solvents should not be used for the maintenance of the prosthesis. Baby shampoo or boiled salty water is safer for this process.
  • Artificial tears are very useful when using the prosthesis.
  • Some eye gunk may occur when using a prosthesis. They can be cleaned with wet cotton or eye wipes.
  • You should visit a doctor for an eye control in cases of excessive eye gunk.
  • It is useful for patients using eye prosthesis to wear an unbreakable glass (polycarbonate) eyeglass. This is also important for the protection of the other eye.
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Address

Küçükbakkalköy Mh. Şenlik Sk.
No:9 K:6 D:8 Ataşehir İstanbul

Phone

+90 216 302 0157
+90 542 597 5739