The eye may lose its visual function and anatomical shape as a result of trauma, painful eye pressure, eye tumors, and some surgeries. It is necessary to evacuate this eye so that it does not harm the other healthy eye. In this case, it is necessary to fill the gap in the eye socket and make prostheses that are aesthetically compatible with the color and size of the other eye.
Is eye removal necessary for an eye prosthesis? Can’t a prosthesis be made without removal?
This question is asked a lot in our daily practice. Even if it doesn’t work, our patients don’t want their eyes removed. As a result of some diseases, our eyes may lose their ability to see, but the eye is healthy in terms of anatomical shape. There is no need to drain these eyes and there is no need for a prosthesis. However, it is necessary to evacuate the eye in patients whose intraocular tissues are damaged after eye tumor, trauma, or various intraocular surgeries, in patients who cannot cope with drug treatment, which we call endophthalmitis or panophthalmitis, in patients with serious eye infections, in patients with phthisis, that is, shrunken eyes, or in patients with painful end-stage glaucoma because there is a small chance that these eyes will damage the other healthy eye.
How is eye prosthesis surgery performed?
We can think of this process as two stages.
1. Surgery phase:
In order for the prosthetic eye to be smooth and compatible with the eye and eyelids, the eye socket must be ready for the prosthesis. The eyes to be prosthetic are usually either small, anatomically deformed, or sometimes very large. In the first stage, intraocular tissues are surgically removed and a ball-like substance, which we call a sphere, is placed inside the eye. The surgery is mostly performed with general anesthesia. Surgery time is between 30 and one hour. Our patients do not need to stay in hospital.
2. Prosthesis construction phase:
Prosthesis-making phase: The prosthesis-making phase can be started approximately 2 months after the surgery.
How is recovery after surgery? When can a prosthesis be made?
Some swelling and redness is expected after the surgery. This swelling and redness will go away after about a week or ten days. We usually discharge our patients on the same day after the surgery, but sometimes we may need to keep them in the hospital for a day. We use dissolvable stitches during surgery. These stitches dissolve and fall off on their own after about one to one and a half months. After approximately 2 months, the eye socket becomes suitable for the prosthesis and the prosthesis construction phase can be started.
Can removable prosthesis be made?
This is the most important and frequently asked question. The prosthetic eye never acts like the healthy eye. However, some movement can be gained to the prosthetic eye with some surgical techniques and, of course, provided that the patient’s eye is suitable. The prosthetic eye has two important focuses of movement.
1. Movement of the eye under the prosthesis:
The movement of this part varies depending on the preoperative structure of the eye, its size, anatomical shape, the shape and structure of the ball placed into the eye by surgery, and of course the surgical technique.
2. Transferring movement from the eye to the prosthesis:
It is very important to transfer the movement of the lower eye to the prosthesis. Therefore, there must be smart points between the eye and the prosthesis, so to speak. For a while, it was possible to provide very good movement to the prosthesis with the help of a screw between the ball placed inside the eye and the prosthesis, but when these connection screws constantly became infected and this became the source of the problem, these kinds of prostheses were abandoned. Transferring this movement to the prosthesis depends on the balance between the prosthesis and the eye, the size of the prosthesis, the smart movement points in the eye, the compatibility of the prosthesis and this smart point, and the lubricity of the prosthesis.
How is a prosthetic eye made? Do I need to have surgery again for this?
This process has two stages. The first stage is surgery, the second stage is the prosthesis-making stage. No surgery is performed at this stage. Molds suitable for your eye socket are made. The prosthesis is made according to these molds, your eye color, the vascularity in the white of your eye, and your eye size.
Can I use a ready-made prosthesis?
We definitely do not recommend ready-made dentures. Because the harmony and balance of the prosthesis and the lower eye is very important. If there is an imbalance, over time the lower eye, eyelids, and the depression on the inside of the lids, which we call the fornix, will be damaged. Over time, it may become such that even a prosthesis cannot be used.
Do I need to remove my prosthetic eye at night? How should it be maintained?
A prosthetic eye is not like a contact lens. You do not need to remove it every day, but we recommend that you remove it and cleanse it once a week or every 10 days before going to sleep. You do not need to clean your prosthesis with special care or cleaning materials. Just clean it with soap and water.
Is the prosthetic eye long-lasting? Is it necessary to check?
Both the prosthesis itself and the eye underneath need to be checked at regular intervals of 6 months. Because over time, problems may arise in both the prosthesis and the underlying eye structure. These problems need to be solved before they escalate. The prosthesis may also have problems over time, such as wear and tear or loss of lubricity, and may need to be replaced.