Natural Movement for the Artificial Eye
Right, woman with Bio-eye Hydroxyapatite Orbital Implant.
Change and movement
When our bodies change in some way, due to injury or disease, we are understandably
concerned about how our lives may be affected. This is especially true of changes that
involve some part of the face, such as the eyes.
Until recently, those facing the loss of an eye had little hope of recovering the
natural movement of the normal eye. Most of us know someone who has an artificial eye that
lacks movement or a natural appearance.
Today, thanks to remarkable advances in orbital implants, the loss of
an eye no longer means the loss of a natural appearance.
Many thousands of people have already benefited from a medical breakthrough that can
create a more natural-looking artificial eye. In fact, you may have met one of these
people, unaware that they had an artificial eye.
Orbital implants and artificial eyes
When an eye is removed, an orbital implant is used to replace the area
in the orbit (bony cavity) that was occupied by the eye. This small, spherical
implant maintains the natural structure of the orbit and provides support
for the artificial eye. The implant itself is not visible however.
An artificial eye is used to restore the natural appearance of the eye and surrounding
tissues, and is the visible part of the surgical changes to the socket (Fig. 1).
Artificial eyes are usually made of plastic (acrylic) or glass. Custom artificial eyes are
hand-crafted by highly skilled ocularists (eye makers) to precisely match the look of the
Figure 1. Orbital implant with artificial eye (shown removed)
While artificial eyes have been made for thousands of years, the first
orbital implants were developed about 100 years ago. These small spheres
of glass or gold were later replaced by plastic or silicone spheres; but
until recently, the basic design of these "first-generation"
implants had changed little over the years.
The need for a better implant
The first-generation implants were a major improvement for those wearing an artificial
eye, but they were unable to deliver natural movement to the artificial eye.
This lack of movement was a major obstacle to restoring a natural appearance, which
made the adjustment to wearing an artificial eye much more difficult.
The first-generation implants also tended to drift (migrate) in the orbit
and were often rejected (extruded) by the tissues of the body, making
further surgeries necessary. These problems inspired researchers to search
for a better orbital implant.
Hydroxyapatite: the natural choice
The goal of a more natural appearance was finally achieved with the help of a natural
material: ocean coral. A remarkable similarity was noticed between the porous structure of
certain coral species and that of human bone.
Soon after this discovery, a method was developed to transform the mineral in coral to
match that of human bone, known as hydroxyapatite.
This naturally derived material has both the porous structure and the chemical
structure of bone (Figs. 2 and 3).
Figure 2. Human Bone (magnified) (43K JPEG)
Figure 3. Hydroxyapatite (magnified) (26K JPEG)
Thus, the tissues of the body will accept-even grow into-these naturally
derived hydroxyapatite implants, and essentially become a "living"
part of the body.
The first hydroxyapatite orbital implant
The first orbital implant made of hydroxyapatite was implanted in 1985
by Arthur Perry, M.D. in San Diego, CA., after several years of preliminary
The eye muscles can be attached directly to this implant, allowing it to move within
the orbit-just like the natural eye.
Some of this movement is automatically transferred to the artificial eye, which fits
over the implant. If greater movement is desired, then a peg is used to connect the
artificial eye to the implant. In this way, even the small, darting movements of the
natural eye can be delivered directly to the artificial eye. The result is a more
natural-looking artificial eye that can be difficult to distinguish from the natural eye
Figure 4. Natural movement with the Bio-eye orbital implant (26K
The Bio-eye Hydroxyapatite Orbital Implant
This unique, patented implant was first cleared by the US Food and Drug Administration
(FDA) in 1989. In addition to natural eye movement, the Bio-eye orbital
implant offers many less-obvious benefits. It reduces implant migration
and extrusion, which were common with the first-generation implants, and
it can prevent drooping of the lower lid (Fig. 5) by lending support to
the artificial eye via a peg connection. These are important benefits
that can eliminate the need to choose between further corrective surgery
and an unsatisfactory appearance.
Figure 5. Natural appearance via good condition of the eyelids.
The benefits of natural movement and fewer long-term problems have made
the Bio-eye orbital implant the implant of choice among leading oculoplastic
You may be a candidate for the Bio-eye orbital implant
You may be a candidate for this procedure if you must have an eye removed (enucleation) or
the contents of an eye removed (evisceration), or if you have previously had one of these
procedures and are not satisfied with your first-generation implant (secondary
You should consult your ophthalmologist or ocularist to determine whether
you could benefit from the Bio-eye orbital implant.
The Bio-eye Hydroxyapatite Orbital Implant is surgically placed within
the orbit at the time the eye is removed, and the tissues are closed over
the implant. A temporary conformer is then placed over the implant and
under the eyelids to maintain the space for the artificial eye.
Eight weeks later, a visit is made to an ocularist. This highly skilled
specialist will create a detailed artificial eye-often astonishing in
its lifelike appearance-that exactly matches your natural eye. The artificial
eye fits over the implant and under the eyelids, and will move as the
implant moves or "tracks" along with the natural eye.
If further movement is desired, your ophthalmologist can perform a simple procedure to
connect the artificial eye to the implant, by means of a peg (Fig. 6). In this optional
procedure, a hole is drilled into the implant and a peg is inserted into the hole. Your
ocularist then modifies the back of the artificial eye to accept the head of the peg, thus
forming a ball-and-socket joint.
Figure 6. Bio-eye orbital implant after tissue ingrowth (optional
peg system shown). (43K JPEG)
The peg-fitting procedure can only be performed after the implant has
had time to fill with tissue from the orbit-usually about six months after
implantation. A bone scan or magnetic resonance imaging (MRI) test can
confirm whether the implant is ready to accept a peg. These tests, as
well as the peg-fitting procedure, are usually painless. Once your ocularist
has properly fit the artificial eye, the full benefits of the Bio-eye
orbital implant will be available to you. Of course, the final results
in each case will vary depending on the condition of the orbit, muscles,
and surrounding tissues.
Consult a medical professional
The Bio-eye hydroxyapatite orbital implant has been described as "a
dream come true" by patients, surgeons, ocularists, and those familiar
with the older, first-generation orbital implants. The benefits of a more
natural appearance and more stable implant material have made this unique
orbital implant the natural choice for those who wear an artificial eye.
Consult your ophthalmologist or ocularist to determine whether you can
benefit from the Bio-eye Hydroxyapatite Orbital Iimplant.
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