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 natural eye.

Figure 1. Orbital implant with artificial eye (shown removed) (43K JPEG)

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 research.

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 (Fig. 4).

Figure 4. Natural movement with the Bio-eye orbital implant (26K JPEG)

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. (26K JPEG)

The benefits of natural movement and fewer long-term problems have made the Bio-eye orbital implant the implant of choice among leading oculoplastic surgeons worldwide.

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 implantation).

You should consult your ophthalmologist or ocularist to determine whether you could benefit from the Bio-eye orbital implant.

The procedure
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.

(26K JPEG)

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