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 Table of Contents  
CASE REPORT
Year : 2015  |  Volume : 1  |  Issue : 2  |  Page : 121-123

A novel simplified functional impression making for prosthetic ocular rehabilitation


Department of Prosthodontics, Post Graduate Institute of Dental Sciences, Pt. B. D. Sharma University of Health Sciences, Rohtak, Haryana, India

Date of Web Publication2-Mar-2016

Correspondence Address:
Manu Rathee
Department of Prosthodontics, Post Graduate Institute of Dental Sciences, Pt. B. D. Sharma University of Health Sciences, Rohtak - 124 001, Haryana
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/2454-3160.177948

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  Abstract 

Successful prosthetic rehabilitation of an ocular defect can be achieved by recording the remaining orbital anatomic structure using a functional impression technique. This clinical report discusses the ocular impression making procedure in a subject with a history of failed ocular implant in eviscerated eye. The problem encountered while making a static ocular impression is a nonfunctional recording of associated musculature, making ocular prosthesis unstable. This case report presents an accurate impression making of the anophthalmic socket using a functional impression technique.

Keywords: Evisceration, impression, ocular prosthesis, ocular tray


How to cite this article:
Rathee M, Bhoria M, Dua M. A novel simplified functional impression making for prosthetic ocular rehabilitation . Saint Int Dent J 2015;1:121-3

How to cite this URL:
Rathee M, Bhoria M, Dua M. A novel simplified functional impression making for prosthetic ocular rehabilitation . Saint Int Dent J [serial online] 2015 [cited 2019 Dec 9];1:121-3. Available from: http://www.sidj.org/text.asp?2015/1/2/121/177948



The loss of vision or removal of an eye is a difficult situation for both the patient and the family members. Such procedure has a significant emotional impact on the patient and family making the prosthetic rehabilitation imperative. The ocular prosthesis is an artificial replacement of the eye and such prosthesis is aimed to enhance aesthetics and encourage the patient to overcome psychological trauma. [1]

Evisceration includes the surgical procedure where the entire intraocular contents are removed, leaving the sclera and orbit intact (with or, more often, without the cornea). In evisceration, most part of the sclera is retained, and the extraocular muscles attachments are preserved. This procedure produces better aesthetic results and implant/prosthetic mobility. There is also less chance of orbital volume changes, evidenced as a retracted supratarsal sulcus or generalized atrophy of the orbital soft tissues. [2],[3] This article discusses an accurate impression making procedure for an eviscerated anophthalmic socket using a functional impression technique for ocular prosthetic rehabilitation.


  Case Report Top


A 25-year-old male presented with chief complaint of missing left eye and history of failed ocular implant in left eviscerated eye [Figure 1]. There was a history of traumatic injury to left eye in childhood. On examination, intraocular tissue was healthy, and adequate depth between the upper and lower fornices for retention of the ocular prosthesis was observed. The lacrimation was also appreciated.
Figure 1: Ocular defect

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Procedure

The thumb rest of syringe plunger (5 ml) was used as custom ocular impression tray to carry the impression material into the socket [Figure 2]. The retention holes were prepared on thumb rest of syringe plunger, and soft putty impression material was loaded and placed into left eviscerated socket [Figure 3]. The long shaft of the plunger was placed perpendicular to the pupil plane of the right natural eye. A functional movement of the adjacent right normal eye was initiated to mould the soft putty into the desired functional-anatomic form. The eyeball movement involved were: Up and down, right and left, wide opening and closing. Once the soft putty was set, the light body polyvinyl impression material was loaded around the putty and inserted into the left eviscerated socket [Figure 4]. A functional movement of the adjacent right normal eye was initiated to mould impression into the desired functional-anatomic form. The impression was evaluated by replacement into the socket. It was passive (least distortion of fatty tissues and eyelids), comparing the palpebral fissure with the adjacent natural eye.
Figure 2: Modified thumb rest of plunger of syringe with retention hole

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Figure 3: Polyvinyl siloxane soft putty impression

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Figure 4: Ocular impression relined using polyvinyl siloxane light body impression material

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The extra impression material was added around the orbit of the eye to pick up associated anatomic contour [Figure 5]. Care was taken that the end of the plunger of the syringe was not fully covered with impression material that served as a handle of the tray for easy retrieval of the impression. After the material had set, the impression was removed easily by holding the plunger extending out uncovered by the impression material. The impression was inspected to verify its completion [Figure 6] and poured into parts to get the three piece master cast. Then, the ocular prosthesis was fabricated on the working cast with appropriate tinted clear acrylic resin. The ocular prosthesis was inserted and regular follow-up was advised [Figure 7].
Figure 5: Impression material added around the orbit to pick up associated anatomic contour

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Figure 6: Functional-anatomic impression of ocular defect

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Figure 7: Prosthesis in situ

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  Discussion Top


The selection of custom ocular tray defines and records existing ocular socket anatomy and precisely conforms to the socket. [4],[5],[6] It helps in obtaining accurate functional impression of the ocular socket. This results in intimate, precise adaptation of the stock eye prostheses to remaining tissue surface of the socket. Prefabricated resin eye is not indicated to be used in eviscerated sockets as intimate contact between the ocular prosthesis and tissue bed is needed to distribute pressure broadly and equally. [3]

For ocular prosthesis to intimately contact the tissue, a functional impression recording is must. This presented impression procedure discusses the utilization of novel, a unique technique of recording the ocular tissue bed through putty wash impression technique making an impression into the desired functional-anatomic form. It makes use of the easily available syringe piston as an impression tray to carry the impression material. Advantages includes the impression can be rechecked while reinserting into ocular socket and assessment involves passivity (least distortion of fatty tissues and eyelids) while comparing palpebral fissure of the adjacent natural eye. The functional-anatomic form recording of ocular socket enhances the intimate adaptation of the ocular prosthesis to the tissue surface of the defect and guides the movement of the ocular prosthesis and enhances its natural appearance.


  Conclusion Top


It is a novel, a unique technique for functional-anatomic ocular impression making using custom impression tray. This technique utilizes a simple, convenient technique of impression making for an ocular prosthesis that enhances the intimate adaptation of the prosthesis to a tissue surface of the defect and facilitates the ocular prosthesis functional movement.

Declaration of patient consent

The authors certify that they have obtained all appropriate patient consent forms. In the form the patient(s) has/have given his/her/their consent for his/her/their images and other clinical information to be reported in the journal. The patients understand that their names and initials will not be published and due efforts will be made to conceal their identity, but anonymity cannot be guaranteed.

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.

 
  References Top

1.
Cain JR. Custom ocular prosthetics. J Prosthet Dent 1982;48:690-4.  Back to cited text no. 1
[PUBMED]    
2.
Taylor TD. Clinical Maxillofacial Prosthesis. Chicago: Quintessence; 2000. p. 265-76.  Back to cited text no. 2
    
3.
Beumer J, Curtis TA, Marunick MT. Maxillofacial Rehabilitation: Prosthodontic and Surgical Considerations. St. Louis: Elsevier; 1996. p. 417-31.  Back to cited text no. 3
    
4.
Mathews MF, Smith RM, Sutton AJ, Hudson R. The ocular impression: A review of the literature and presentation of an alternate technique. J Prosthodont 2000;9:210-6.  Back to cited text no. 4
    
5.
Ow RK, Amrith S. Ocular prosthetics: Use of a tissue conditioner material to modify a stock ocular prosthesis. J Prosthet Dent 1997;78:218-22.  Back to cited text no. 5
    
6.
Taicher S, Steinberg HM, Tubiana I, Sela M. Modified stock-eye ocular prosthesis. J Prosthet Dent 1985;54:95-8.  Back to cited text no. 6
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    Figures

  [Figure 1], [Figure 2], [Figure 3], [Figure 4], [Figure 5], [Figure 6], [Figure 7]



 

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