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

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Abstract

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.

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References

  1. Hatamleh MM, Abbariki M, Alqudah N, Cook AE (2017) Survey of Ocular prosthetics rehabilitation in the United Kingdom, part 1: Anophthalmic patients’ aetiology, opinions, and attitudes. J Craniofac Surg 28:1293–1296. https://doi.org/10.1097/SCS.0000000000003370

    Article  PubMed  Google Scholar 

  2. Bonaque-González S, Amigó A, Rodríguez-Luna C (2015) Recommendations for post-adaption care of an ocular prosthesis: a review. Contact Lens Anterior Eye 38:397–401. https://doi.org/10.1016/j.clae.2015.06.003

    Article  PubMed  Google Scholar 

  3. Choudhury M, Banu F, Natarajan S, Kumar A, Padmanabhan TV (2018) A multidisciplinary approach for rehabilitation of enucleated sockets: ocular implants with custom ocular prosthesis. Cureus 10:e2201. https://doi.org/10.7759/cureus.2201

    Article  PubMed  PubMed Central  Google Scholar 

  4. Goiato MC, Bannwart LC, Haddad MF, Dos Santos DM, Alves Pesqueira A, Issamu Miyahara G (2014) Fabrication techniques for ocular prostheses–an overview. Orbit 33:229–233. https://doi.org/10.3109/01676830.2014.881395

    Article  PubMed  Google Scholar 

  5. Changal N, AlRasheed W, Khandekar R (2020) Ocularists the less known mid eye care professionals and their contribution in eye health care. Saudi J Ophthalmol Off J Saudi Ophthalmol Soc 34:195–197. https://doi.org/10.4103/1319-4534.310403

    Article  Google Scholar 

  6. Baino F, Perero S, Ferraris S, Miola M, Balagna C, Verné E, Vitale-Brovarone C, Coggiola A, Dolcino D, Ferraris D (2014) Biomaterials for orbital implants and ocular prostheses: overview and future prospects. Acta Biomater 10:1064–1087. https://doi.org/10.1016/j.actbio.2013.12.014

    Article  CAS  PubMed  Google Scholar 

  7. Osborn KL, Hettler D (2010) A survey of recommendations on the care of ocular prostheses. Optometry 81:142–145. https://doi.org/10.1097/ICL.0000000000000020

    Article  PubMed  Google Scholar 

  8. Ho VWM, Hussain RN, Czanner G, Heimann H, Damato BE (2017) Porous versus nonporous orbital implants after enucleation for Uveal melanoma: a randomized study. Ophthal Plast Reconstr Surg 33:452–458. https://doi.org/10.1097/IOP.0000000000000824

    Article  PubMed  Google Scholar 

  9. Chinnery H, Thompson SBN, Noroozi S, Dyer B, Rees K (2017) Questionnaire study to gain an insight into the manufacturing and fitting process of artificial eyes in children: an ocularist perspective. Int Ophthalmol 37:1175–1183. https://doi.org/10.1007/s10792-016-0383-4

    Article  PubMed  Google Scholar 

  10. Hintschich C, Baldeschi L (2001) Rehabilitation of anophthalmic patients. Results of a survey. Ophthalmologe 98:74–80. https://doi.org/10.1007/s003470170203

    Article  CAS  PubMed  Google Scholar 

  11. Timothy NH, Freilich DE, Linberg JV (2003) Evisceration versus enucleation from the ocularist’s perspective. Ophthalmic Plast Reconstr Surg 19:417–420. https://doi.org/10.1097/01.IOP.0000096162.94415.98

    Article  PubMed  Google Scholar 

  12. Goiato MC, Zucolotti BRC, Mancuso DN, Dos Santos DM, Pellizzer EP, Verri FR (2010) Care and cleaning of maxillofacial prostheses. J Craniofac Surg 21:1270–1273. https://doi.org/10.1097/SCS.0b013e3181e1b431

    Article  PubMed  Google Scholar 

  13. Parr GR, Goldman BM, Rahn AO (1983) Postinsertion care of the ocular prosthesis. J Prosthet Dent 49:220–224. https://doi.org/10.1016/0022-3913(83)90506-1

    Article  CAS  PubMed  Google Scholar 

  14. Pine KR, Sloan BH, Jacobs RJ (2015). Clinical Ocular Prosthetics. Springer Charm, Switzerland

  15. Ocularists training in the United Kingdom. Available from: http://ocularists.net/education-and-training/ocularist-training-in-the-united-kingdom/.

  16. Maxillofacial Prosthetic Rehabilitation MSc, Kings College University, London. Available from: https://www.kcl.ac.uk/study/postgraduate-taught/courses/maxillofacial-prosthetic-rehabilitation-msc/.

  17. National Examining Board of Ocularists (NEBO). Available from: https://neboboard.org/.

  18. Association of European Ocularists. Available from: https://www.aeo2023.com/.

  19. American Society of Ocularists. Available from: https://ocularist.org/.

  20. Ocularists Association of Australia. Available from: http://ocularistsaustralia.com/

  21. Indian Society of Ocularists. Available from: http://www.ocularist.co.in/.

  22. Ocularists Association of Southern Africa. Available from: http://www.oasa.org.za/.

  23. International Anaplastology Association. Aailable from: https://www.anaplastology.org/

  24. International Academy of Ocularistry. Available from: https://www.academyofocularistry.org/

  25. Rokohl AC, Koch KR, Adler W, Trester M, Trester W, Pine NS, Pine KR, Heindl LM (2018) Concerns of anophthalmic patients-a comparison between cryolite glass and polymethyl methacrylate prosthetic eye wearers. Graefes Arch Clin Exp Ophthalmol 256:1203–1208. https://doi.org/10.1007/s00417-018-3942-8

    Article  CAS  PubMed  Google Scholar 

  26. Rokohl AC, Mor JM, Trester M, Koch KR, Heindl LM (2019) Rehabilitation of Anophthalmic patients with prosthetic eyes in germany today—supply possibilities, daily use, complications and psychological aspects. Klin Monbl Augenheilkd 236:54–62. https://doi.org/10.1055/a-0764-4974

    Article  PubMed  Google Scholar 

  27. Quaranta-Leoni FM, Fiorino MG, Quaranta-Leoni F, Di Marino M (2021) Anophthalmic socket syndrome: prevalence, impact and management strategies. Clin Ophthalmol 15:3267–3281. https://doi.org/10.2147/OPTH.S325652

    Article  PubMed  PubMed Central  Google Scholar 

  28. Rokohl AC, Trester M, Mor JM, Loreck N, Koch KR, Heindl LM (2019) Customizing a Cryolite glass prosthetic eye. J Vis Exp 31:152. https://doi.org/10.3791/60016

    Article  CAS  Google Scholar 

  29. Rokohl AC, Trester M, Mor JM, Pine KR, Heindl LM (2019) Risk of breakage of cryolite glass prosthetic eyes. Graefes Arch Clin Exp Ophthalmol 257:437–438. https://doi.org/10.1007/s00417-018-4155-x

    Article  PubMed  Google Scholar 

  30. Litwin AS, Worrell E, Roos JCP, Edwards B, Malhotra R (2018) Can we improve the tolerance of an ocular prosthesis by enhancing its surface finish? Ophthal Plast Reconstr Surg 34:130–135. https://doi.org/10.1097/IOP.0000000000000891

    Article  PubMed  Google Scholar 

  31. Rokohl AC, Adler W, Koch KR, Mor JM, Jia R, Trester M, Pine NS, Pine KR, Heindl LM (2019) Cryolite glass prosthetic eyes-the response of the anophthalmic socket. Graefes Arch Clin Exp Ophthalmol 257:2015–2023. https://doi.org/10.1007/s00417-019-04395-y

    Article  CAS  PubMed  Google Scholar 

  32. Rokohl AC, Koch KR, Trester M, Trester W, Pine KR, Heindl LM (2018) Concerns of Anophthalmic patients wearing Cryolite glass prosthetic eyes. Ophthalmic Plast Reconstr Surg 34(4):369–374. https://doi.org/10.1097/IOP.0000000000001021

    Article  PubMed  Google Scholar 

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Acknowledgements

To all the participants in the survey.

Funding

The authors have not disclosed any funding.

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Authors and Affiliations

  1. Department of Ophthalmology-Oculoplastic, Rio Hortega University Hospital, Valladolid, Spain

    Elvira Martinez-Fernandez, Hortensia Sanchez-Tocino & Alicia Galindo-Ferreiro

  2. Botucatu Medical School, Universidade Estadual Paulista Júlio de Mesquita Filho, São Paulo State University (UNESP), Botucatu, Brazil

    Carolina Pereira Bigheti, Denise Moreira Zornoff & Silvana Artioli Schellini

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  1. Elvira Martinez-Fernandez
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  3. Hortensia Sanchez-Tocino
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  6. Alicia Galindo-Ferreiro
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Contributions

EM-F and CPB collected data and wrote the manuscript. HS-T and DMZ reviewed material, method and helped with statistics. SAS and AG-F reviewed the whole manuscript.

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Correspondence to Alicia Galindo-Ferreiro.

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Martinez-Fernandez, E., Pereira Bigheti, C., Sanchez-Tocino, H. et al. Management of external ocular prosthesis by ocularists: results of an online survey conducted in Brazil and Spain. Int Ophthalmol 43, 4297–4304 (2023). https://doi.org/10.1007/s10792-023-02841-9

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