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Augenprothetische Versorgung

Anpassung, Handhabung und Komplikationen

Ocular prosthetics

Fitting, daily use and complications

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Zusammenfassung

Hintergrund

Die augenprothetische Versorgung ist aus funktionellen, ästhetischen und psychosomatischen Gründen entscheidend für die Rehabilitation nach okulärer Exstirpation.

Fragestellung

Es soll ein Überblick über Anpassung, Handhabung und Komplikationen von Augenprothesen gegeben werden.

Methoden

Der Beitrag bietet eine Literaturübersicht aus PUBMED und eigene klinische Ergebnisse.

Ergebnisse

Augenprothesen, aus Glas oder Kunststoff gefertigt, können 5 bis 8 Wochen postoperativ angepasst werden. Bis dahin sollte ein Konformer getragen werden, um einer die Prothesenfähigkeit bedrohenden Vernarbung der Bindehautfornices vorzubeugen. Kunstaugen können kontinuierlich getragen werden, unterbrochen von einer kurzen regelmäßigen Reinigung mit individuell festzulegendem Intervall. Tränenersatzmittel und Lidkantenpflege bessern den Tragekomfort. Glasprothesen müssen alle 1 bis 2 Jahre erneuert, Kunststoffprothesen 1-mal im Jahr poliert werden. Komplikationen wie die gigantopapilläre Konjunktivitis oder eine Blepharokonjunktivitis sicca werden durch schlechten Prothesensitz, hohes Prothesenalter und unzureichende Pflege begünstigt. Bei Socketschrumpfungen oder dem anophthalmischen Socketsyndrom muss die Prothesenfähigkeit chirurgisch wiederhergestellt werden.

Schlussfolgerungen

Korrekte Anpassung, Handhabung und Pflege von Augenprothesen sowie eine adäquate Therapie möglicher Komplikationen sind maßgeblich, um Patienten nach okulärer Exstirpation dauerhaft funktionell, ästhetisch und psychosomatisch zu rehabilitieren.

Abstract

Background

Ocular prosthetics make a decisive contribution to the functional, esthetic and psychosomatic rehabilitation of patients after ocular extirpation.

Objectives

This article provides an overview of the fitting, daily care and complications of ocular prosthetics.

Methods

The study comprised a PubMed literature review and own clinical results.

Results

Ocular prosthetics made from cryolite glass or perspex can be manufactured and fitted 5–8 weeks after removal of the eye. During this period a conformer is placed within the conjunctival sac in order to prevent scar formation and shrinking of the socket. Artificial eyes can be worn continuously, only interrupted by a short but regular cleaning procedure. Artificial tears and lid hygiene improve the comfort of wearing. Glass prostheses have to be renewed every 1–2 years, while perspex prostheses need to be polished once a year. Complications, such as giant papillary conjunctivitis or blepharoconjunctivitis sicca are facilitated by poor fit, increased age and inappropriate care of the prosthetic device. In the case of socket shrinkage or anophthalmic socket syndrome, surgical interventions are needed to re-enable the use of an artificial eye.

Conclusion

Adequate fitting, daily care of ocular prosthetics and therapeutic management of associated complications are mandatory for a durable functional, esthetic and psychosomatic rehabilitation after ocular extirpation.

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Authors and Affiliations

  1. Zentrum für Augenheilkunde, Uniklinik Köln, Kerpener Straße 62, 50924, Köln, Deutschland

    K. R. Koch, C. Cursiefen & L.M. Heindl

  2. Institut für Augenprothetik Trester, Köln, Deutschland

    W. Trester & M. Trester

  3. Institut für Kunstaugen und ophthalmologische Hilfsmittel, Wiesbaden, Deutschland

    N. Müller-Uri

Authors
  1. K. R. Koch
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  2. W. Trester
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  3. N. Müller-Uri
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  4. M. Trester
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  5. C. Cursiefen
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  6. L.M. Heindl
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Corresponding author

Correspondence to K. R. Koch.

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K.R. Koch, W. Trester, N. Müller-Uri, M. Trester, C. Cursiefen und L.M. Heindl geben an, dass kein Interessenkonflikt besteht.

Dieser Beitrag beinhaltet keine Studien an Menschen oder Tieren.

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Koch, K., Trester, W., Müller-Uri, N. et al. Augenprothetische Versorgung. Ophthalmologe 113, 133–142 (2016). https://doi.org/10.1007/s00347-015-0091-x

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  • DOI: https://doi.org/10.1007/s00347-015-0091-x

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