The influence of the locomotor stump’s form on the ocular prosthetics result with different methods of eye removal

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Aim. To determine the optimal shape of the locomotor stump and the configuration of the corresponding ocular prosthesis, ensuring their maximum motility in patients with anophthalmia with different methods of eye removal.

Materials and methods. The study group consisted of 132 patients aged 18–80 years after enucleation or evisceration. Examination methods included medical history; examination of eyelids, measurement of length and width of the palpebral fissure, as well as of the depth of conjunctival fornices on both sides; assessment of the volume, shape, surface topography, position and excursions of the locomotor stump, of the protrusion of the ocular prosthesis compared to the contralateral eye; photo registration of the studied parameters.

Results. During the study, there were 3 types of locomotor stump identified: moderate with retraction in the upper third; voluminous flattened; voluminous hemispherical. The locomotor stump after enucleation was voluminous flattened or moderate with retraction in the upper third. The best motility of the locomotor stump was noted nasally and downward. The motility of the ocular prosthesis was 47.4% compared to the contralateral eye. The locomotor stump after evisceration with keratectomy was voluminous hemispherical or voluminous flattened. Its motility in all four directions was about the same. The motility of the ocular prosthesis in comparison to the contralateral eye was 55.9%. The locomotor stump after evisceration without keratectomy was voluminous hemispherical, uniform, smooth. The motility of the locomotor stump was maximal in comparison to other groups and relatively equal in all four directions. The motility of the ocular prosthesis in comparison to the contralateral eye was 68.2%.

Conclusion. The optimal shape of the locomotor stump, providing the greatest motility of the ocular prosthesis is voluminous hemispherical. The same protrusion of the eyeball and that of the cosmetic prosthesis relatively to the frontal plane after enucleation is achieved by increasing the thickness of the prosthesis itself, which reduces its motility. Evisceration with implantation of the orbital prosthesis involves the use of a thin-walled ocular prosthesis, the back surface of which ideally repeats the locomotor stump surface and does not prevent its maximum motility. When removing a squinting eyeball with preserved corneal diameter, a smaller implant should be used to prevent excessive opening of the palpebral fissure, or to prefer evisceration with keratectomy.

作者简介

Nadezhda Baranova

Saint Petersburg Diagnostic Center No. 7 (Ophthalmological) for Adults and Children

编辑信件的主要联系方式.
Email: baranova-n@bk.ru

Ophthalmologist, Head, Laboratory of Ocular Prosthesis

俄罗斯联邦, Saint Petersburg

Irina Senina

Saint Petersburg Diagnostic Center No. 7 (Ophthalmological) for Adults and Children

Email: i.senina@mail.ru

Ophthalmologist

俄罗斯联邦, Saint Petersburg

Vadim Nikolaenko

Saint Petersburg State Hospital No. 2; Saint Petersburg State University

Email: dr.nikolaenko@mail.ru

MD, PhD, Professor, Otorhinolaryngology and Ophthalmology Chair of Medical Faculty

俄罗斯联邦, Saint Petersburg

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