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Coussa RG, Lomis N, Antaki F, Samle J, Patel K, Christodoulou G, Prakash S, Oestreicher J, Arthurs B. Blink detection and magnetic force generation for correction of lagophthalmos, with specific regard to implant compatibility testing. Orbit 2020; 41:59-68. [PMID: 33016160 DOI: 10.1080/01676830.2020.1826544] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
PURPOSE The overall goal was to restore a normal and synchronous blink in unilateral lagophthalmos. We describe the biocompatibility profiling of a novel ferromagnetic implant used for electromagnetic eyelid force generation. METHODS A non-contact blink detection system and an electromagnetic stimulation system were designed and tested. A modified Lester-Burch speculum equipped with strain gauge technology was used in blinking force measurement. Samarium-cobalt magnets were prototyped and coated with parylene-C. Biocompatibility testing was performed using NIH/3T3 mouse fibroblast cells with MTT colorimetric assay cytotoxic quantification. OUTCOME MEASURES Cellular viability and interleukin concentrations. RESULTS Our system was capable of detecting 95.5 ± 3.6% of blinks in various lighting conditions. Using our force measuring device, the difference between non-paralyzed and paralyzed orbicularis oculi (OO) for normal and forceful blinking closure was 40.4 g and 101.9 g, respectively. A 16.6 × 5.0 × 1.5 mm curved shaped samarium cobalt eyelid implant was successfully developed and showed a reproducible blink at 100 ms with full corneal coverage with external eyelid taping. Compared to gold weights, parylene-C coated samarium cobalt implants showed not only excellent cell viability (82.0 ± 4.9% vs. 88.4 ± 0.9%, respectively, p > .05), but also below detection threshold for pro-inflammatory marker concentrations (interleukin-6 < 2 pg/mL and interleukin-10 < 3 pg/mL). CONCLUSIONS We demonstrated excellent in-vitro biocompatibility of our parylene-C coated samarium cobalt implants. We believe that our novel approach can improve the quality-of-life of affected individuals and provides new understanding of blinking biomechanics.
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Affiliation(s)
- Razek Georges Coussa
- Department of Ophthalmology and Visual Sciences, Carver College of Medicine, University of Iowa, Iowa City, Iowa, USA.,Department of Ophthalmology and Visual Sciences, McGill University Health Center, Montreal, Quebec, Canada.,Biomedical Technology and Cell Therapy Research Laboratory, Department of Biomedical Engineering, McGill University, Montreal, Quebec, Canada
| | - Nikita Lomis
- Biomedical Technology and Cell Therapy Research Laboratory, Department of Biomedical Engineering, McGill University, Montreal, Quebec, Canada
| | - Fares Antaki
- Department of Ophthalmology and Visual Sciences, McGill University Health Center, Montreal, Quebec, Canada.,Department of Ophthalmology, Université De Montréal, Montreal, Quebec, Canada
| | - Jason Samle
- Department of Ophthalmology and Vision Sciences, University of Toronto, Toronto, Ontario, Canada
| | - Kavita Patel
- Department of Ophthalmology and Vision Sciences, University of Toronto, Toronto, Ontario, Canada
| | | | - Satya Prakash
- Biomedical Technology and Cell Therapy Research Laboratory, Department of Biomedical Engineering, McGill University, Montreal, Quebec, Canada
| | - James Oestreicher
- Department of Ophthalmology and Vision Sciences, University of Toronto, Toronto, Ontario, Canada
| | - Bryan Arthurs
- Department of Ophthalmology and Visual Sciences, McGill University Health Center, Montreal, Quebec, Canada
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Pathak C, Pawah S, Sikri A, Rexwal P, Aggarwal P. Lip and Lower Lid Supporting Prosthetic Appliance: A Unique Approach of Treating Unilateral Facial Paralysis. J Clin Diagn Res 2017; 11:ZD09-ZD11. [PMID: 28658922 DOI: 10.7860/jcdr/2017/27142.9876] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2017] [Accepted: 03/30/2017] [Indexed: 11/24/2022]
Abstract
Along with function, aesthetics plays an important role in treating partially or completely edentulous patients. Ageing, trauma, tooth loss and neuromuscular disorders have a high impact on tonicity of facial musculature, elasticity of skin as well as function of muscles. Patients affected with Bell's palsy face functional, aesthetic as well as psychological impairment. Common problems are the partial closure of upper eyelid, sagging of lower eyelid and drooping of angle of mouth leading to facial asymmetry, along with difficulty in eating, drinking and speaking. The key to aesthetic restoration is to support and harmonize the collapsed facial musculature with the help of various prosthodontic treatment approaches. This case report attempts to focus on treating completely edentulous patient affected with Bell's palsy with special prosthesis supporting angle of mouth and lower eyelid using novel technique.
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Affiliation(s)
- Chetan Pathak
- Senior Lecturer, Department of Prosthodontics and Crown and Bridge, Sudha Rustagi College of Dental Sciences and Research, Faridabad, Haryana, India
| | - Salil Pawah
- Professor and Head, Department of Prosthodontics and Crown and Bridge, Sudha Rustagi College of Dental Sciences and Research, Faridabad, Haryana, India
| | - Arpit Sikri
- Senior Lecturer, Department of Prosthodontics and Crown and Bridge, Sudha Rustagi College of Dental Sciences and Research, Faridabad, Haryana, India
| | - Pushpanjali Rexwal
- Faculty, Department of Prosthodontics and Crown and Bridge, Sudha Rustagi College of Dental ScIences and Research, Faridabad, Haryana, India
| | - Prachi Aggarwal
- Senior Lecturer, Department of Prosthodontics and Crown and Bridge, Sudha Rustagi College of Dental Sciences and Research, Faridabad, Haryana, India
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Da Costa GC, Aras MA, Chalakkal P, Da Costa MC. Ocular prosthesis incorporating IPS e-max press scleral veneer and a literature review on non-integrated ocular prosthesis. Int J Ophthalmol 2017; 10:148-156. [PMID: 28149792 PMCID: PMC5225364 DOI: 10.18240/ijo.2017.01.24] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2016] [Accepted: 07/05/2016] [Indexed: 11/23/2022] Open
Abstract
The article highlights a new method for the fabrication of an ocular prosthesis by the incorporation of a ceramic scleral veneer. The steps of fabrication include impression making, wax try-in, performing a "cut-back" on a selected stock eye, insertion of the IPS e-max press scleral veneer, finishing and insertion. It also includes a detailed review on non-integrated ocular prostheses.
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Affiliation(s)
- Godwin Clovis Da Costa
- Department of Prosthodontics, Goa Dental College and Hospital, Bambolim, Goa 403202, India
| | - Meena Ajay Aras
- Department of Prosthodontics, Goa Dental College and Hospital, Bambolim, Goa 403202, India
| | - Paul Chalakkal
- Department of Pedodontics and Preventive Dentistry, Goa Dental College and Hospital, Bambolim, Goa 403202, India
| | - Michelle Clovis Da Costa
- Primary DNB (Ophthalmology), West Lion's Super Specialty Eye Hospital, Bangalore, Karnataka 560002, India
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Reddy PSS, Abraham P, Kumar V. Prosthodontic and surgical management of anophthalmia: a case report. J Indian Prosthodont Soc 2014; 14:120-3. [PMID: 24605009 DOI: 10.1007/s13191-012-0157-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2012] [Accepted: 07/10/2012] [Indexed: 11/30/2022] Open
Abstract
True Anophthalmos is an extremely rare condition and can cause psychological problems due to not only the absence of an eye but also from the disfigurement of the orbital socket and the eyelids. The present case shows the multidisciplinary approach in the treatment of a patient with anophthalmos. He needed an ocular plastic surgery for correct prosthesis insertion. The disfigurement caused by the loss of ocular content when restored with prosthesis maintains the facial symmetry there by improves the esthetics as well as anatomic and physiological function.
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Affiliation(s)
- P Satheesh Simha Reddy
- Department of Prosthodontics, Army College of Dental Science, Secunderabad, Andhra Pradesh India ; Siddhartha Dental Clinic, Siddhartha Apartments, Opposite State Home, Yousufguda Road, Ellareddyguda, Hyderabad, 500073 India
| | - Ponsekar Abraham
- Department of Prosthodontics, S.R.M. Dental College, Chennai, Tamilnadu India
| | - Vasantha Kumar
- Department of Prosthodontics, S.R.M. Dental College, Chennai, Tamilnadu India
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Gunaseelaraj R, Karthikeyan S, Kumar MN, Balamurugan T, Jagadeeshwaran AR. Custom-made ocular prosthesis. J Pharm Bioallied Sci 2012; 4:S177-9. [PMID: 23066246 PMCID: PMC3467907 DOI: 10.4103/0975-7406.100264] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2011] [Revised: 01/02/2012] [Accepted: 01/26/2012] [Indexed: 11/29/2022] Open
Abstract
An ocular defect may affect a patient psychologically. An ocular prosthesis is given to uplift the patient psychologically and improve the confidence. Ocular prosthesis can be custom made or a stock shell. To improve the comfort and matching of the prosthesis with that of the adjacent natural eye an custom made ocular prosthesis is preferred. Different techniques are available to fabricate a custom ocular prosthesis, here we have used paper iris disk technique.
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Affiliation(s)
- Rajkumar Gunaseelaraj
- Department of Prosthodontics, J. K. K. Natrajah Dental College and Hospital, Komarapalayam, Tamil Nadu, India
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Patient satisfaction after lid loading in facial palsy. Eur Arch Otorhinolaryngol 2009; 266:1727-31. [PMID: 19396612 DOI: 10.1007/s00405-009-0981-0] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2009] [Accepted: 04/06/2009] [Indexed: 10/20/2022]
Abstract
Paralytic lagophthalmos is treated by pretarsal implantation of eyelid weights consisting either of rigid gold weights or flexible platinum chains. Functional results being good, subjective patient satisfaction has been examined only by a small number of studies. The aim of our study, conducted by means of a questionnaire, was to assess subjective patient satisfaction after implantation of different eyelid implants. Questionnaires were sent to 42 patients treated by pretarsal implantation of a gold weight (group 1) and 51 patients with a pretarsally fixed platinum chain (group 2). In total, 46 response sheets were evaluated (16 x gold weight, 30 x platinum chain) and the results were compared. In group 1, 75% of patients were very satisfied to satisfied with the overall result. In group 2, 100% of patients were very satisfied to satisfied with the overall result. In group 1, an infection occurred in 6.5% of patients, an extrusion in 6.5%, and a change of vision in 31%. In group 2, inflammation occurred in 13%, extrusion in 0%, and a change of vision occurred in 13% of patients. On a visual analogous scale from 1 to 10 (1, very good; 10, very poor), group 1 assessed the cosmetic result with an average grade of 3.8 and the functional result with an average grade of 3.1. Group 2 assessed the cosmetic result with the grade 2.9 and the functional result with grade 3.0. The implantation of an eyelid weight for treatment of paralytic lagophthalmos was assessed as positive by a majority of patients. When compared with conventional gold implants, patients who have been treated with a flexible platinum chain are overall more satisfied and have a more favorable subjective view of the cosmetic results.
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Abstract
Patients with lagophthalmos are often treated with a stock gold weight that has been implanted in the upper eyelid. This relatively simple surgical technique does not, however, always produce the desired result. This article describes a technique for the fabrication of a custom eyelid implant prosthesis for patients who present with a non-functioning and unaesthetic eyelid implant.
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Affiliation(s)
- Mijin Choi
- Restorative Department, Baltimore College of Dental Surgery, University of Maryland, USA
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Berghaus A, Neumann K, Schrom T. The platinum chain: a new upper-lid implant for facial palsy. ARCHIVES OF FACIAL PLASTIC SURGERY 2003; 5:166-70. [PMID: 12633207 DOI: 10.1001/archfaci.5.2.166] [Citation(s) in RCA: 74] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
BACKGROUND When using upper-lid gold implants in facial palsy, a certain percentage of undesired effects and complications are known to occur (eg, astigmatism, pseudoptosis, migration, bulging, and extrusion). Our flexible platinum chain implant adapts better to the changing radius of the tarsus with movement of the globe and reduces the complication rate. Platinum implants are smaller, owing to their higher density. OBJECTIVE To compare the results with 33 gold and 30 platinum chain implantations. METHODS Clinical follow-up study at a university otorhinolaryngology department. The mean follow-up was 11 months in the gold-implant group and 9 months in the platinum-implant group. The treatment consisted of pretarsal fixation of the metal weights to the upper lid. MAIN OUTCOME MEASURES Criteria for evaluation of results include reduction of lagophthalmos and keratopathy and gain of visual acuity. Complications that have been assessed include astigmatism, bulging, migration, pseudoptosis, and extrusion of implants. We evaluated histological samples of the implant bed and performed ultrasound measurements of the tarsal radius. RESULTS The restoration of lid closure was a visual and aesthetic improvement for all patients. We found a tendency toward a higher rate of complications with gold implants compared with platinum chains, especially for astigmatism and bulging. Ultrasonographic measurements showed ongoing flexibility of the platinum chains after implantation, and histological findings confirmed their good biocompatibility. CONCLUSIONS Flexible platinum chain implants lead to better results with fewer complications compared with standard rigid gold implants.
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Affiliation(s)
- Alexander Berghaus
- Department of Otorhinolaryngology-Head and Neck Surgery, Martin-Luther-University Halle-Wittenberg, Magdeburger Strasse 12, Halle D-06097, Germany.
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Abstract
The loss of an eye is often followed by scar tissue contracture. The purpose of this article is to describe a procedure for fabricating acrylic resin ocular custom-made conformers to maintain socket size and contour. These custom-made ocular conformers act as an interim measure and as valuable diagnostic indicators of problems experienced by the patients. While stock conformers merely maintain the socket size and prevent scar tissue contractures, the custom-made conformers can also be used to enlarge unfavorably small sockets, stimulate eyelid movement, aid hygiene, help the clinician develop the final shape for the definitive prosthesis, and reduce the amount of postinsertion adjustments needed. These advantages and the ease of fabrication make custom-made conformers a viable initial treatment option in patients with ocular defects.
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Affiliation(s)
- L M Sykes
- School of Oral Health Sciences, University of the Witwatersrand, Johannesburg, South Africa.
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Meades K. A dental prosthesis to close the palpebral fissure. AUSTRALIAN AND NEW ZEALAND JOURNAL OF OPHTHALMOLOGY 1997; 25:173. [PMID: 9267607 DOI: 10.1111/j.1442-9071.1997.tb01302.x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Affiliation(s)
- K Meades
- Sydney Eye Hospital, NSW, Australia
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