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Case of the Month Whats Going On This Month On occasion we see patients who have been wearing a prosthesis for 15-20 years and sometimes longer without ever changing it. In many of these cases the patients come in knowing their prosthesis does not fit properly. They expect us to correct the problems, unfortunately not realizing the defects have gradually developed as a result of not having the prosthesis changed as anatomical changes in the socket have occured. In many instances these problems could have been avoided by having the prosthesis evaluated once or twice a year so the defects can be corrected as they occur or develop before they reach the point that surgery is the only option for the patient to be able to maintain a prosthesis. We recently had a patient referred to us who had a secondary enucleation. The original implant came out. This probably was a result of not replacing their prosthesis as needed. The person only had 3 prostheses over a span of 50 years, resulting in chronic infection and implant extrusion. They also had been fit with stock eyes. Additionaly, the socket contracted leaving very little room for a prosthesis. The plan of action is now to use conformers to expand the socket, before we make the new prosthesis which will allow for a better functioning prosthesis. This could have been avoided with regular polishings and refittings. Remember, the plastic is good for about 5 years. A newer prosthesis will have less discharge, in most instances. The patient had become used to constant discharge, not realizng how this conditioned worsened over time. In many instances we can correct minor problems such as upper or lower lid ptosis, or excessive discharge because of the plastic being old or having porosity, and for normal anatomical socket changes. However many defects which have become apparent from years of neglect, may benefit from oculoplastic surgery. It is always our intention to correct problems using creative fitting techniques, but when that is not possible, we will refer the patient back to the surgeon for evaluations or alternative recommendations. We are proud to say we have purchased the newest in digital photo and computer equipment so we can show the patient what we belive we can and cannot achive before making the prosthesis, which allows the patient to feel more confident with our recommendation. E-mail us now:
administration@prostheticeye.com |
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