Background: Eyes are an important component of the face and vital organs of vision. Eye loss can be caused by congenital defects, trauma, or tumor. Loss of an eye produces physical abnormalities that pose a psychological burden on the patient, as well as visual function damage. An ocular prosthesis is an artificial maxillofacial prosthesis to replace the lost eye. Case summary: A 54-year-old man consults at the Prosthodontics Specialist Universitas Airlangga Dental Hospital for an eye prosthesis. The patient did not have the right eyeball since birth. Soft tissue around the eye is normal, including the palpebral muscles. Case management: An impression was made using a custom tray and alginate in the defect area, followed by filling the impression with gypsum type 3 to get a working model, from which a wax model is made and adjusted to the patient. After that, sclera and ocular acrylic prostheses are made on the basis of an adjusted wax model. The prosthesis is then polished and colored according to the contralateral eye. Then the prosthesis is delivered to the patient. Conclusion The hollow custom-made eye prosthesis can be considered in the treatment of anophthalmia. It is able to improve the patient's psychological and emotional status.
Eye ; Eye, Artificial ; Social Determinants of Health

PURPOSE: To evaluate and compare the efficacy and sensation of instillation between 0.05% cyclosporine nanoemulsion group and microemulsion group. METHODS: This is a double-blind, prospective randomized clinical trial. Patients had 2 weeks of wash-out period before the study. They were randomly assigned to either nanoemulsion group or microemulsion group and treated with each group's cyclosporine eye drop. Artificial eye drop and topical steroid were used together according to severity of dryness of cornea. We checked every patient's Break-up time (BUT), Schirmer test, Staining Score and Ocular surface disease index (OSDI) on baseline, 1 month and 3 months after. Patients also self-checked frequency of use of artificial eye drop and topical steroid. Sensation of instillation was also checked. RESULTS: Both nanoemulsion eye-drop and microemulsion eye-drop improved BUT, Schirmer test, Staining Score and OSDI throughout 12 weeks. The nanoemulsion type reduced OSDI significantly compared to the microemulsion type. The mean frequency of use of artificial tear and topical steroid was similar in both groups. Foreign body sense score was higher in microemulsion group. CONCLUSIONS: 0.05% cyclosporine nanoemulsion type has simillar efficacy and subjectively less foreign body sensation.
Cornea ; Cyclosporine ; Dry Eye Syndromes ; Eye, Artificial ; Foreign Bodies ; Humans ; Prospective Studies ; Sensation ; Tears

PURPOSE: We sought to evaluate the outcomes of external dacryocystorhinostomy (DCR) and mono-canalicular intubation in patients with total obstruction of one canalicus. METHODS: Sixteen eyes of 16 patients with nasolacrimal duct obstruction and a single canaliculus obstruction who had undergone external DCR and monocanalicular intubation of the intact canaliculus were retrospectively included in the present study. The monocanalicular tube (Mini Monoka) was left in place for at least two months. Munk epiphora grading for the evaluation of epiphora and irrigation was performed both preoperatively and at 6 months postoperatively. RESULTS: Mean patient age was 46 ± 14.2 (range, 18 to 76) years. The inferior canaliculus was obstructed in nine eyes (group A) and the superior canaliculus was obstructed in seven eyes (group B), respectively. Eight eyes had chronic dacryocystitis and two of these eyes also had a history of acute dacryocystitis attack. Mean preoperative Munk scores were 3.89 in group A and 4.0 in group B. Ocular surface irritation occurred in one eye in group A. Artificial eye drops were prescribed and early tube removal was not performed. Spontaneous tube dislocation was recorded in one eye in group B. No other corneal, punctal, or canalicular complications were found. At six months, irrigation of intact canaliculus was patent in all eyes. Mucoid discharge, conjunctival hyperemia, and chronic conjunctivitis were also resolved. Postoperative Munk scores were 1.11 ± 0.9 in group A and 0.86 ± 0.9 in group B. Of note, preoperative and postoperative Munk scores were significantly different in both groups (group A, p = 0.006; group B, p = 0.017). The postoperative Munk scores were not statistically different between the two groups (p = 0.606). CONCLUSIONS: In patients with nasolacrimal duct obstruction and a total of one canaliculus obstruction, external DCR and monocanalicular intubation of the intact canaliculus is an effective surgical option.
Conjunctivitis ; Dacryocystitis ; Dacryocystorhinostomy ; Dislocations ; Eye, Artificial ; Humans ; Hyperemia ; Intubation ; Lacrimal Apparatus Diseases ; Lacrimal Duct Obstruction ; Nasolacrimal Duct ; Retrospective Studies

OBJECTIVES: The iris is the part of the eye that is colored, and it is an important feature in making an artificial eye. To address the lack of information about the brown Korean irises, we classified the colors and patterns of the irises of 100 Korean eyes. METHODS: The iris colors were extracted from 100 different digital photographs of each eye using K-mean clustering image analysis. The RGB data of the extracted colors were converted to CIELAB color space data and analyzed to determine the representative color of the iris in each photograph. The color differences were calculated to form groups of similar colors by matching the 100 samples into several groups with minimum color differences among them. The average hue value for each group was calculated, and the corresponding representative color was selected from 2 to 3 colors in one group. RESULTS: The iris colors were classified into seven brown color groups with 2 to 3 colors in each group. The coloration of Koreans' eyes appears to vary in a similar hue with differences in chroma and lightness. In addition, the iris patterns were classified into three basic patterns, namely, crown, sunshine, and flower, as well as three complex patterns that are mixtures of two basic patterns. CONCLUSIONS: We classified Korean iris colors and patterns for application in the design of artificial eyes.
Asian Continental Ancestry Group ; Classification* ; Crowns ; Eye, Artificial ; Flowers ; Humans ; Iris* ; Sunlight

PURPOSE: To investigate the clinical results of patients who have undergone simultaneous dermo-fat graft and insertion of orbital implants in patients who are unable to put on an ocular prosthesis due to severe conjunctival sac contracture or large orbital implant exposure. METHODS: A retrospective analysis was performed of patients who underwent dermo-fat graft simultaneously with orbital implant insertion for replacement of the conjunctival sac from 2007 to 2012. Eight eyes were enrolled in this study and all patients were followed up for phthisis bulbi or implant exposure. RESULTS: Among the eight eyes, five eyes (62.5%) that were diagnosed with orbital implant exposure underwent orbital implant exchange and dermo-fat graft, and two eyes (25%) were anophthalmic enophthalmic patients and underwent secondary orbital implant insertion and dermo-fat graft. One patient (12.5%) underwent orbital implant insertion and dermo-fat graft simultaneously during the evisceration operation. We followed the progress for 46.3 months. For seven out of eight eyes, the results of the wound healing process were successful. One patient underwent removal and reinsertion of the orbital implant with dermo-fat graft, and the wound in this case healed well. However, after five months, dermo-fat re-graft was performed for orbital implant re-exposure and it was not exposed thereafter. Overall cosmetic appearance was satisfactory in each patient, and all patients were able to comfortably retain a prosthesis. CONCLUSIONS: We found that undergoing dermo-fat graft simultaneously when performing orbital implant insertion is effective for replacement of the conjunctival sac and orbital volume.
Anophthalmos* ; Contracture ; Eye, Artificial ; Humans ; Orbit ; Orbital Implants* ; Prostheses and Implants ; Retrospective Studies ; Transplants* ; Wound Healing ; Wounds and Injuries

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.
Anophthalmos ; Dextrans ; Dry Eye Syndromes ; Eye, Artificial* ; Humans ; Hyaluronic Acid ; Needles ; Ophthalmic Solutions* ; Polyethylene Glycols ; Polymethyl Methacrylate ; Polysorbates ; Povidone ; Propylene Glycol ; Silicones ; Sodium ; Tears* ; Wettability*

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.
Anophthalmos ; Dextrans ; Dry Eye Syndromes ; Eye, Artificial* ; Humans ; Hyaluronic Acid ; Needles ; Ophthalmic Solutions* ; Polyethylene Glycols ; Polymethyl Methacrylate ; Polysorbates ; Povidone ; Propylene Glycol ; Silicones ; Sodium ; Tears* ; Wettability*

Three-electrode testing method was used to investigate the effect of temperature on electrode impedance, and the pH shifts in saline solution resulting from the electrical stimulation were also determined. Experiments in PBS (phosphate buffered solution) solution showed that the electrode impedance was almost invariable at the human body temperature range (35 degrees C-40 degrees C). And the experiments in unbuffered saline solution showed that pH shifts decreased from 0.03 to 0.005 when the frequency of biphasic charged-balanced pulses increased from 1 Hz to 100 Hz. Even stimulated by monophasic pulses (frequency is 15 Hz, amplitude is 50 microA), the stimulus-induced pH shift of electrode only varies 0.15 (anodic pulse current increased 0.15 and cathodic pulse current decreased 0.15).
Electrochemistry ; Eye, Artificial ; Materials Testing ; Microelectrodes ; Prostheses and Implants

PURPOSE: To investigate the biologic effects of preservative-free artificial tear drops on cultured human corneal epithelial cells in vitro. METHODS: Efficacies of the preservative-free artificial tear drops-Kynex(R), Hyalein Mini 0.3%(R), and Refresh Plus(R)-were evaluated using the MTT assay. Cell damage was determined using the lactate dehydrogenase (LDH) assay. Cellular proliferation was determined using a migration and wound-healing assay. The ingredients of the drugs were analyzed. Apoptotic response was evaluated with flow cytometric analysis. RESULTS: Metabolic activity of the corneal epithelial cells showed similar activity to that of the control. Cellular migration and proliferation also were not significantly different between the preservative-free artificial tear drop groups and the control. The LDH titers tended to increase for up to 24 hours after exposure to the preservative-free artificial tear drops, but there was no significant difference in LDH titers between the control groups and the artificial tear drop-treated groups. Apoptosis and necrosis were observed using flow cytometry at 24 hours in all groups. The electrolyte levels, pHs and osmolarities of the three drugs were not significantly different. CONCLUSIONS: The clinically available preservative-free artificial tear drops Kynex(R), Hyalein Mini 0.3%(R), and Refresh Plus(R) had no significant toxic effects on corneal epithelial cells and thus can be used safely.
Apoptosis ; Cell Proliferation ; Epithelial Cells ; Eye, Artificial ; Flow Cytometry ; Humans ; Hydrogen-Ion Concentration ; L-Lactate Dehydrogenase ; Necrosis ; Osmolar Concentration ; Tears

A 59-year-old woman underwent explorative laparotomy under general anesthesia for mechanical ileus. The patient had rectal cancer with multiple metastasis, and was receiving 1.5-2 mg of intravenous morphine per hour due to severe abdominal pain. After about 3 hours of general anesthesia, the patient was extubated and transferred to postanesthesia care unit. The patient was supplied with 6 L/min of oxygen by facial mask. In 30 minutes, the patient showed no response to verbal order and pain stimulus with sluggish eye reflex, although pulse-oximeter showed 98-99%. After emergent intubation, arterial blood gas was sampled, and the result showed severe acidosis with hypercapnia. The patient was transferred to intensive care unit, and after 1 hour of mechanical ventilation the patient became conscious then fully recovered without further complication.
Abdominal Pain ; Acidosis ; Anesthesia, General ; Carbon Dioxide ; Coma ; Eye ; Female ; Humans ; Hypercapnia ; Ileus ; Intensive Care Units ; Intubation ; Laparotomy ; Masks ; Middle Aged ; Morphine ; Neoplasm Metastasis ; Oxygen ; Rectal Neoplasms ; Reflex ; Respiration, Artificial