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Recent developments in orbital implant technology have placed new demands on those who practice the art and science of ocularistry. Improvements in technology bring increased expectations on the part of both patients and healthcare professionals. With the reintroduction of "peggable implants," finally made successful by the unique physical and chemical characteristics of the Bio-eye Hydroxyapatite (HA) Orbital Implant, the opportunity for ocularists to create a highly motile, fully supported prosthesis has been greatly improved. The most comprehensive survey of leading surgeons to date reported that surgeons now prefer to use a motilty/support peg in 73% of enucleations and eviscerations, and in 53% of secondary implantations (Hornblass 1992).
Continuing developments in the motility/support peg systems employed with the Bio-eye Hydroxyapatite Orbital Implant, and the tendency of surgeons to use the peg to access all available socket movement, have lead to new techniques and theories on the means of crafting an eye that is capable of delivering the full potential of the new orbital implants.
Ophthalmologists are often unaware of the constraints they place on the ocularist by their choice among surgical techniques. An implant that is too large or too small, or one that is not placed properly in the orbit, can severely limit the ocularist's options in his attempt to create a lifelike artificial eye. Conversely, the benefits of an excellent surgical result cannot be enjoyed by the patient unless the ocularist uses the latest techniques to craft a lifelike eye that can also access all of the motility available in the socket.
The key to achieving the best cosmetic result lays in continuing education and communication among the patient, surgeon, and ocularist. When each member of the team is aware of the expectations, talents, capabilities, and constraints of the others, the best final result can be achieved.