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Background: Ocular prosthesis rehabilitation has an important social, psychological, esthetic, and functional role. Congenital factors, trauma, and tumors, among others, can cause anophthalmia, and it is essential to identify the etiology to guide its prevention and treatment. Methods: The aim of this study was to retrospectively investigate the records of patients treated from 2013 to 2020 by the Oral and Maxillofacial Prosthesis Group, aiming to identify the prevalence of patients with anophthalmia and the etiology of their anophthalmia. After approval by the Human Research Ethics Committee, two calibrated researchers evaluated 520 records, identifying those from patients with anophthalmia. The inclusion criteria were records with complete and legible information from patients with anophthalmia and a description of their etiology. Descriptive statistics were performed, and etiological factors were categorized into trauma, congenital cause, end-stage eye disease, and tumor. Spearman's correlation was performed to verify the relation between gender and anophthalmia etiology, with a 5% significance level. Seventy-two records were included in the study. Results: It was observed that 33.4% of patients were women and 66.6% were men. The etiologies were physical trauma (52.4%), tumor (21.8%), end-stage eye disease (16.6%), and congenital cause (9.2%), and there was no correlation between gender and these etiologies (p = .301). Conclusion: Most of the cases identified were of traumatic origin, which allows the establishment of preventive and educational measures to avoid new cases of anophthalmia.

RESUMO

BACKGROUND: Polymethylmethacrylate (PMMA) is the most used material for the manufacturing of eye prostheses. OBJECTIVES: To investigate the cytotoxicity of different cleaning agents for ocular prostheses on human conjunctival cells. MATERIAL AND METHODS: Six groups of specimens were created (saline, soap, 4% chlorhexidine, hydrogen peroxide, 1% triclosan, and citronella oil). Three specimens were made for each disinfectant at each disinfection period (1, 7, 15, 30, 60, and 90 days), totaling 108 specimens. Thus, the specimens were disinfected, with different disinfectants, for different periods of time. After each disinfection process, the specimens were washed with sterile distilled water. A human conjunctival cell line was grown on the acrylic resin specimens and then cytotoxicity tests (MTT and Neutral Red (NR)) were performed. A negative control (untreated cell cultures) and positive control (Tween 20) were created. Two-way analysis of variance (ANOVA) and Bonferroni test were performed (p < 0.05). RESULTS: For the MTT and NR tests, when there was a significant difference between the disinfectant and negative control, the disinfectant generated a significant reduction in cell proliferation most of the time. CONCLUSIONS: All reductions in cell proliferation caused by the disinfectants were clinically acceptable. All disinfectants tested in this study were found to be non-cytotoxic to human conjunctival cells.

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Introducción: La prótesis ocular es un medio artificial con fines funcional y estético, que posibilita la rehabilitación física, psíquica y social de pacientes con defectos en los ojos. Objetivo: Describir la evolución de los pacientes con prótesis ocular según signos de infección en las cavidades oculares rehabilitadas, factores de riesgos asociados, así como modificaciones en la forma de la cavidad y/o en la prótesis ocular. Métodos: Se realizó un estudio observacional, longitudinal y prospectivo de 74 pacientes aquejados por defectos oculares, que recibieron tratamiento protésico en el período de 2018 a 2019 en la Clínica de Rehabilitación Bucomaxilofacial de Santiago de Cuba, los cuales fueron evaluados a través de una encuesta y un examen clínico en tres momentos durante un año de evolución. Para establecer la asociación entre variables, se emplearon la prueba de la Χ2 de Pearson y la exacta de Fisher de acuerdo con el cumplimiento de supuestos. Resultados: De los 222 exámenes efectuados a las cavidades oculares rehabilitadas, 31 revelaron la presencia de secreciones en 23 pacientes, con recurrencia en 8 de ellos; dicho signo clínico se manifestó de manera similar a la hipercoloración de la conjuntiva en cuanto al momento del hallazgo y al grupo etario afectado, con mayores porcentajes al año de evolución y una incidencia superior en los pacientes de 60 y más años de edad. Asimismo, se constató una asociación estadísticamente significativa de las variables higiene diaria de la cavidad y de la prótesis con la existencia de secreciones, para un intervalo de confianza de 95 %. Conclusiones: Se demostró la ventaja del aseo semanal de la cavidad ocular y de la prótesis en sus portadores, pues con ello se disminuye la frecuencia de los signos inflamatorios e infecciosos de la mucosa, lo que debe observarse con mayor rigurosidad en los ancianos, quienes resultan ser los más afectados.

Introduction: Ocular prosthesis is an artificial means with functional and cosmetic ends that facilitates the physical, psychic and social rehabilitation of patients with eyes defects. Objective: To describe the evolution of patients with ocular prosthesis according to infection signs in the rehabilitated ocular cavities, associated risk factors, as well as modifications in the form of the cavity and/or in the ocular prosthesis Methods: An observational, longitudinal and prospective study of 74 patients suffering from eye defects that received prosthetist treatment from 2018 to 2019 in the oral maxillofacial Rehabilitation Clinic was carried out in Santiago de Cuba, who were evaluated through a survey and a clinical exam in three moments during a year of evolution. To establish the association between variables, the Pearson chi-square and Fisher exact tests were used with the fulfillment of suppositions. Results: Of the 222 exams made to the rehabilitated ocular cavities, 31 revealed the presence of secretions in 23 patients, with recurrence in 8 of them; this clinical sign became evident in a similar way to the hypercoloring of the conjunctiva as for the moment of the finding and the age group affected, with higher percentages at the year of evolution and a higher incidence in the patients of 60 years and over. Also, an association statistically significant of the daily hygiene of the cavity and prosthesis variables with the existence of secretions was verified, for a confidence interval of 95 %. Conclusions: The advantage of the ocular cavity and prosthesis weekly personal cleanliness was demonstrated, because with it the frequency of the inflammatory and infectious signs of the mucous is reduced, what should be strictly observed in elderly, who are the most affected.

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PURPOSE: To investigate the influence of nonthermal plasma (NTP) treatment on the tensile bond strength between heat-polymerized acrylic resin for ocular prostheses and silicone reliner, with and without the use of an adhesive primer. MATERIALS AND METHODS: One-hundred and sixty-four acrylic resin specimens were fabricated and randomly distributed into four groups according to the type of surface treatment: Sofreliner Primer, NTP, Sofreliner Primer + NTP, and NTP + Sofreliner Primer. Two specimens interposed with relining material (Sofreliner) formed one test sample to perform the tensile bond strength tests, before (initial) and after storage (final) in saline solution (37°C, 90 days, n = 10). Surface characterization was performed by scanning electron microscopy (SEM) and energy dispersive spectroscopy (EDS). The failure type was classified as cohesive, adhesive, or mixed. The data were analyzed statistically using the two-way ANOVA and Tukey test, as well as the chi-squared test (α = 0.05), Bonferroni correction (α = 0.005), and Spearman correlation coefficient (α = 0.05). RESULTS: The SEM and EDS analyses showed the presence of a thin, homogenous organic film in the groups treated with NTP. The NTP + Sofreliner Primer group presented the largest bond strength mean values in the initial period (p < 0.05). Sofreliner Primer and NTP + Sofreliner Primer groups presented the first and second largest tensile bond strength mean values in the final period (p < 0.05), respectively. NTP + Sofreliner Primer group also had the largest number of cohesive (70%, initial) and mixed (90%, final) failures. CONCLUSIONS: The NTP treatment performed before the primer application enhanced the bond between the acrylic resin ocular prosthesis and the Sofreliner silicone-based reliner, even after 90 days of immersion in saline solution.

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Introdução: A prótese ocular visa à reparação aloplástica das perdas ou deformidades do bulbo ocular, tendo por objetivos recuperar a estética facial; prevenir o colapso e a deformidade palpebral; proteger a cavidade anoftálmica contra agressões por poeira, fumaça ou poluentes; restaurar a direção da secreção lacrimal e prevenir o acúmulo deste fluido na cavidade evitando as alterações assimétricas que progressivamente se instalam. Objetivo: relatar um caso clínico de reabilitação de paciente anoftálmico bilateral por meio de prótese ocular. Material e método: Para a realização do procedimento, a cavidade anoftálmica do paciente foi moldada com alginato. Esse molde foi incluído em mufla para obtenção da esclera artificial em Resina Acrílica Ocular Termicamente Ativada (RAOTA) cor N2. A esclera obtida foi provada no paciente e recebeu os ajustes necessários. Em seguida, foi realizada a centralização da pupila, feito o platô e pintada a íris artificial, que foi colada sobre o platô. Toda a superfície da esclera recebeu caracterização e o conjunto foi recoberto com RAOTA incolor. Por fim, a prótese recebeu acabamento, polimento, e foi instalada. O paciente foi instruído quanto ao uso e higienização. Resultado: Foi observado que após a instalação da prótese, a estética facial do indivíduo foi restaurada, o suporte palpebral restabelecido e o direcionamento lacrimal corrigido, além da reinserção do indivíduo ao convívio social. Conclusão: o tratamento reabilitador atingiu seu objetivo de restaurar a estética facial e foi de grande importância para o paciente, pois o mesmo resgatou a autoestima e pôde retornar ao convívio social sem constrangimentos(AU)

Introduction: The ocular prosthesis aims at the alloplastic repair of the losses or deformities of the ocular bulb, aiming to recover the facial esthetics; prevent collapse and eyelid deformity; protect the anophthalmic cavity against aggression from dust, smoke or pollutants; restore the direction of lacrimal secretion and prevent the accumulation of this fluid in the cavity avoiding the asymmetric changes that progressively install. Objective: to report a clinical case of rehabilitation of bilateral anophthalmic patient by ocular prosthesis. Material and method: To perform the procedure, the patient's anophthalmic cavity was cast with alginate. This template was included in muffle to obtain artificial sclera in thermally activated ocular acrylic resin (RAOTA) color N2. The obtained sclera was tested on the patient and received the necessary adjustments. Afterwards, the pupil was centralized, made the plateau and painted the artificial iris, which was glued on the plateau. The entire surface of the sclera was characterized and the whole was covered with colorless RAOTA. Finally, the prosthesis was finished, polished, and installed. The patient was instructed in the use and hygiene. Results: It was observed that after the installation of the prosthesis, the individual's facial aesthetics were restored, the eyelid support was restored and the corrected lacrimal targeting was performed, as well as the reinsertion of the individual into social interaction. Conclusion: the rehabilitation treatment reached its goal of restoring the facial aesthetics and was of great importance for the patient, since it rescued the self-esteem and was able to return to the social life without constraints(AU)

Introducción: La prótesis ocular se refiere a la reparación aloplástica de las pérdidas o deformidades del bulbo ocular, teniendo como objetivo recuperar la estética facial; prevenir el colapso y la deformidad palpebral; proteger la cavidad anoftálmica contra agresiones por polvo, humo o contaminantes; restaurar la dirección de la secreción lagrimal y prevenir la acumulación de este fluido en la cavidad evitando los cambios asimétricos que progresivamente se instalan. Objetivo: relatar un caso clínico de rehabilitación de paciente anoftálmico bilateral por medio de prótesis oculares. Material y método: Para la realización del procedimiento, la cavidad anoftálmica del paciente fue moldeada con alginato. Este molde fue incluido en mufla para la obtención de la esclera artificial en Resina Acrílica Ocular Termalmente Activada (RAOTA) color N2. La esclera obtenida fue probada en el paciente y recibió los ajustes necesarios. A continuación, se realizó la centralización de la pupila, hecha la meseta y pintada el iris artificial, que fue pegada sobre la meseta. Toda la superficie de la esclera recibió caracterización y el conjunto fue recubierto con RAOTA incoloro. Por último, la prótesis recibió el acabado, pulido, y se instaló. El paciente fue instruido en cuanto al uso e higienización. Resultado: Se observó que después de la instalación de la prótesis, la estética facial del individuo fue restaurada, el soporte palpebral restablecido y el direccionamiento lagrimal corregido, además de la reinserción del individuo a la convivencia social. Conclusión: el tratamiento rehabilitador alcanzó su objetivo de restaurar la estética facial y fue de gran importancia para el paciente, pues el mismo rescató la autoestima y pudo regresar a la convivencia social sin limitaciones(AU)

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This clinical report describes the ocular rehabilitation of a child, initially using an acrylic expander and subsequently the conventional prosthesis. A two-month-old anophthalmic female patient was referred to Araçatuba Dental School, for rehabilitation with ocular prosthesis. The treatment chosen was the manufacturing of expander prostheses changed periodically until the socket reached an adequate size, so that a definitive ocular prosthesis could be installed. The acrylic expander remained in patient's anophthalmic socket for 60 days in order to restore its volume. After this period, ocular prosthesis was installed and replaced according to facial growth. It can be observed that the expander prostheses increased the anophthalmic cavity and provided patient's adaptation for using an ocular prosthesis. The ocular prosthesis set the face aesthetic balance which eventually reflects positively on psychological and social development of the child.

RESUMO

A tentativa do homem em restaurar aloplasicamente a região bucomaxilofacial mutilada é tão antiga quanto a formação das civilizações, tendo em vista a importância do olho como uma das estruturas mais importantes na individualização e harmonia da face. Na atualidade, algumas entidades públicas promovem atendimentos a pacientes mutilados que necessitam de uma reabilitação por meio de Prótese Bucomaxilofacial (PBMF), sendo a maior procura pelas oftalmopróteses devido ao grande número de traumas nessa região da face. A prótese ocular é importante para reconstruir a estética, embelezar o rosto cuja harmonia está comprometida, promover a sustentação e a tonicidade muscular palpebral, proteger a cavidade anoftálmica, evitar atresias, entre outros. Tal reabilitação faz parte dos cuidados necessários e representa uma conquista de melhor qualidade de vida para os pacientes e suas famílias. Neste trabalho, os relatos de dois casos clínicos visam apresentar duas reabilitações com oftalmopróteses individualizadas em pacientes com idades diferentes e etiologia da anoftalmia também distintas que resultaram em estéticas favoráveis. Após a confecção das próteses, foi observado que a reabilitação protética anterior ao desenvolvimento ou agravamento de dificuldades de relações interpessoais tende a melhorar a qualidade de vida, visto que a queixa principal quando inexistente melhora o desenvolvimento psicossocial dos pacientes... (AU)

Man’s attempt to restore so alloplastic the maxillofacialregion is as old as the formation of civilizations. Given the importance of the eye as the most significant structure in the individualization and harmony of the face. Nowadays some public entities promote special care to patients who need a mutilated rehabilitation through Maxillofacial Prosthodontics (MFP), the highest demand is for eye prosthesis due to the large number of injuries in this region of the face. The ocular prosthesis aims to reconstruct the aesthetic, beautify the face whose harmony is committed to promote and support the eyelid muscle tone, protect the anophthalmic socket, avoid closure, among others.Such rehabilitation is part of palliative care and is an achievement of better quality of life for patients and their families. In this study, reports of two cases aim to present two eye prosthesis individualized rehabilitation in patients with different ages and different etiology of anophthalmic also resulted in favorable aesthetic. Thus it can be concluded that the prosthetic rehabilitation prior to the development or worsening of interpersonal difficulties relations tends to improve the quality of life of patients, since the main complaint nonexistent improves psychosocial development of these... (AU)

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This study investigated the effects of the ocular prosthesis fabrication technique and the paint on the color stability of the artificial iris button before and after polymerization of the colorless resin. Sixty samples simulating artificial eyes were made, including 30 samples with blue- and 30 samples with sepia-colored artificial irises. Ten samples were made by each of three techniques (i.e., conventional, prefabricated cap, and inverted painting) for each color. The color of the artificial iris button was measured through reflection spectrophotometry by the CIE L*a* b* system before and after polymerization of the prosthesis (colorless resin). Data were evaluated by analysis of variance (ANOVA) and the Tukey honestly significant different (HSD) tests (α=0.05). All of the samples exhibited color changes. Samples made by the prefabricated cap technique exhibited the highest color change values for both colors (P<.05). The inverted painting technique exhibited the lowest color change values for the sepia-colored artificial irises (P<.05). Sepia-colored artificial irises exhibited lower color change values than blue-colored artificial irises for both techniques (P<.05). In conclusion, the technique used to obtain the ocular prosthesis significantly affected the stability of the artificial iris color for each color tone and the conventional technique and the painting technique inverted were considered clinically acceptable for sepia color.

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Foi avaliada a conveniência do emprego do cimento de alfa-fosfato tricálcico de dupla pega como implante para o preenchimento de cavidade anoftálmica de cães. Os animais foram provenientes do Serviço de Oftalmologia do Hos- pital Veterinário, da Universidade Estadual Paulista – Câmpus de Jaboticabal e de uma clínica privada. O trabalho foi realizado em dois anos. A idade dos pacientes oscilou entre 2 a 11 anos e o peso de 9 a 50 kg. Os implantes variaram de 19 a 25 mm de diâmetro. O edema local foi observado em todos os animais durante o pós-operatório imediato. Das dez cirurgias realizadas em sete animais, em nove (90%) o resultado estético foi satisfatório, enquanto em um (10%) foi insatisfatório, devido a complicações que levaram à remoção do implante. A utilização do cimento de alfa-fosfato tri- cálcico de dupla pega no preenchimento de cavidade anoftálmica mostrou-se factível e é uma alternativa que possibilita boa aparência estética após a remoção do bulbo do olho.

The double-setting alpha-tricalcium phosphate bone cement was evaluated as an orbital implant for filling the ano- phthalmic cavity of dogs. The animals were from the Ophthalmology Unit of the Veterinary Hospital, Universidade Estadual Paulista – Jaboticabal, and from a private veterinary clinic. The study was conducted during two years. The patients’ age ranged from 2-11 years old, and their weight from 9-50 kg. The implants ranged from 19 to 25 mm in diameter. Local edema was observed in all animals during the immediate postoperative period. Of the ten performed surgeries in seven animals, a satisfactory, aesthetic result was observed in nine (90%) while in one (10%) of them it was unsatisfactory due to complications that led to the implant removal. The use of the double-setting alpha-tricalcium phosphate bone cement to fill anophthalmic sockets is feasible and could be an alternative to improve the cosmetic appearance after eyeball removal.

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As próteses oculares são responsáveis pela recuperação da estética e auto-estima do usuário. Assim, os materiais utilizados na confecção de prótese ocular devem possuir propriedades específicas para sua indicação e durabilidade principalmente aos procedimentos de desinfecção pelo paciente. Desse modo, este estudo teve como objetivo verificar a efetividade de diferentes soluções desinfetantes na remoção de biofilme de duas espécies de Staphylococcus spp., desenvolvidas na superfície de resina acrílica específica para prótese ocular e avaliar a alteração de cor de botões de íris artificiais confeccionadas por diferentes técnicas antes e após a polimerização e quando influenciadas pela desinfecção química. Para o teste de microbiologia, 396 amostras em resina acrílica para prótese ocular N1 foram confeccionadas (1,0 cm em diâmetro e 0,3 cm em espessura), sendo metade dessas amostras para formação de biofilme de S. epidermidis e a outra metade para formação de biofilme de S. aureus, ambos na superfície da amostra. Para cada cepa bacterina, 66 amostras foram submetidas a formação de biofilme em sua superfície durante três diferentes tempos: inicial (24h), intermediário (48h) e maduro (72h). Em seguida as amostras foram distribuídas aleatoriamente (unidade amostral n=6) para um dos tratamentos desinfetantes: água destilada durante 10, 15, 30 min e 6 h (controle-CTL); sabão neutro (NES) durante 30 min; Opti-Free durante 30 min e 6 h; Efferdent (EFF) durante 15 min; e gluconato de clorexidina (0,5%; 2% e 4%) (CHX) durante 10 min. Após o tratamento desinfetante, as amostras acrílicas foram imediatamente agitadas para desprendimento do biofilme. A contagem de colônias foi verificada por análise do número de UFC/mL. Para a análise de alteração de cor 300 amostras simulando próteses oculares foram confeccionadas, sendo metade dessas amostras com íris artificial na cor azul e a outra metade na cor marrom. Para cada cor, cinquenta amostras de cada técnica empregada...

Considering that ocular prostheses restore esthetics and patient’s self-esteem, the materials used for prosthesis fabrication should present appropriate properties regarding indication and reliability after the disinfection procedures. So, the aim of this study was to assess the effectiveness of different disinfectant solutions against two species of Staphylococcus spp. cultured on ocular prosthesis acrylic resin. In addition, the chromatic change of artificial iris buttons fabricated with different techniques was also evaluated before and after polymerization and disinfection. For the microbiology tests 396 acrylic specimens were fabricated (1.0 cm in diameter and 0.3 cm in thickness). Half of the samples were made for biofilm formation of S. epidermidis and half were made for biofilm formation of S. aureus, both on the sample surface. For each strain, 66 samples were underwent to biofilm formation on the liner surface for three different points: initial (24h), intermediate (48h) and mature (72h). Afterwards the specimens were randomly assigned (unit sample n = 6) to one of disinfectant treatments: distilled water for 10, 15, 30 min and 6 h (control-CTL); treated with neutral soap (NES) for 30 min; treated with Opti-Free (OPT) for 30 min and 6 h; treated with Efferdent (EFF) for 15 min; and treated with (0.5%, 2% and 4%) chlorhexidine gluconate (CHX) for 10 min. After the treatments, the specimens were vortexed to disrupt the biofilm, and residual cells were counted (cell/mL). For the color meansurations a total of 300 samples simulating ocular prosthesis were fabricated. Half of the samples were made with blue artificial irises, and half were made with brown artificial irises. For each color, 50 samples were fabricated according to one of the following techniques: PE – conventional technique, CA – prefabricated cap, and PI – inverted painting. A total of 10 specimens of each technique was submitted to disinfection with neutral soap (NES), Opti-Free (OPF)...

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As próteses oculares são responsáveis pela recuperação da estética e auto-estima do usuário. Assim, os materiais utilizados na confecção de prótese ocular devem possuir propriedades específicas para sua indicação e durabilidade principalmente aos procedimentos de desinfecção pelo paciente. Desse modo, este estudo teve como objetivo verificar a efetividade de diferentes soluções desinfetantes na remoção de biofilme de duas espécies de Staphylococcus spp., desenvolvidas na superfície de resina acrílica específica para prótese ocular e avaliar a alteração de cor de botões de íris artificiais confeccionadas por diferentes técnicas antes e após a polimerização e quando influenciadas pela desinfecção química. Para o teste de microbiologia, 396 amostras em resina acrílica para prótese ocular N1 foram confeccionadas (1,0 cm em diâmetro e 0,3 cm em espessura), sendo metade dessas amostras para formação de biofilme de S. epidermidis e a outra metade para formação de biofilme de S. aureus, ambos na superfície da amostra. Para cada cepa bacterina, 66 amostras foram submetidas a formação de biofilme em sua superfície durante três diferentes tempos: inicial (24h), intermediário (48h) e maduro (72h). Em seguida as amostras foram distribuídas aleatoriamente (unidade amostral n=6) para um dos tratamentos desinfetantes: água destilada durante 10, 15, 30 min e 6 h (controle-CTL); sabão neutro (NES) durante 30 min; Opti-Free durante 30 min e 6 h; Efferdent (EFF) durante 15 min; e gluconato de clorexidina (0,5%; 2% e 4%) (CHX) durante 10 min. Após o tratamento desinfetante, as amostras acrílicas foram imediatamente agitadas para desprendimento do biofilme. A contagem de colônias foi verificada por análise do número de UFC/mL. Para a análise de alteração de cor 300 amostras simulando próteses oculares foram confeccionadas, sendo metade dessas amostras com íris artificial na cor azul e a outra metade na cor marrom. Para cada cor, cinquenta amostras de cada técnica empregada...

Considering that ocular prostheses restore esthetics and patient’s self-esteem, the materials used for prosthesis fabrication should present appropriate properties regarding indication and reliability after the disinfection procedures. So, the aim of this study was to assess the effectiveness of different disinfectant solutions against two species of Staphylococcus spp. cultured on ocular prosthesis acrylic resin. In addition, the chromatic change of artificial iris buttons fabricated with different techniques was also evaluated before and after polymerization and disinfection. For the microbiology tests 396 acrylic specimens were fabricated (1.0 cm in diameter and 0.3 cm in thickness). Half of the samples were made for biofilm formation of S. epidermidis and half were made for biofilm formation of S. aureus, both on the sample surface. For each strain, 66 samples were underwent to biofilm formation on the liner surface for three different points: initial (24h), intermediate (48h) and mature (72h). Afterwards the specimens were randomly assigned (unit sample n = 6) to one of disinfectant treatments: distilled water for 10, 15, 30 min and 6 h (control-CTL); treated with neutral soap (NES) for 30 min; treated with Opti-Free (OPT) for 30 min and 6 h; treated with Efferdent (EFF) for 15 min; and treated with (0.5%, 2% and 4%) chlorhexidine gluconate (CHX) for 10 min. After the treatments, the specimens were vortexed to disrupt the biofilm, and residual cells were counted (cell/mL). For the color meansurations a total of 300 samples simulating ocular prosthesis were fabricated. Half of the samples were made with blue artificial irises, and half were made with brown artificial irises. For each color, 50 samples were fabricated according to one of the following techniques: PE – conventional technique, CA – prefabricated cap, and PI – inverted painting. A total of 10 specimens of each technique was submitted to disinfection with neutral soap (NES), Opti-Free (OPF)...

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Foi avaliada a conveniência do emprego do cimento de alfa-fosfato tricálcico de dupla pega como implante para o preenchimento de cavidade anoftálmica de cães. Os animais foram provenientes do Serviço de Oftalmologia do Hos- pital Veterinário, da Universidade Estadual Paulista Câmpus de Jaboticabal e de uma clínica privada. O trabalho foi realizado em dois anos. A idade dos pacientes oscilou entre 2 a 11 anos e o peso de 9 a 50 kg. Os implantes variaram de 19 a 25 mm de diâmetro. O edema local foi observado em todos os animais durante o pós-operatório imediato. Das dez cirurgias realizadas em sete animais, em nove (90%) o resultado estético foi satisfatório, enquanto em um (10%) foi insatisfatório, devido a complicações que levaram à remoção do implante. A utilização do cimento de alfa-fosfato tri- cálcico de dupla pega no preenchimento de cavidade anoftálmica mostrou-se factível e é uma alternativa que possibilita boa aparência estética após a remoção do bulbo do olho.(AU)

The double-setting alpha-tricalcium phosphate bone cement was evaluated as an orbital implant for filling the ano- phthalmic cavity of dogs. The animals were from the Ophthalmology Unit of the Veterinary Hospital, Universidade Estadual Paulista Jaboticabal, and from a private veterinary clinic. The study was conducted during two years. The patients age ranged from 2-11 years old, and their weight from 9-50 kg. The implants ranged from 19 to 25 mm in diameter. Local edema was observed in all animals during the immediate postoperative period. Of the ten performed surgeries in seven animals, a satisfactory, aesthetic result was observed in nine (90%) while in one (10%) of them it was unsatisfactory due to complications that led to the implant removal. The use of the double-setting alpha-tricalcium phosphate bone cement to fill anophthalmic sockets is feasible and could be an alternative to improve the cosmetic appearance after eyeball removal.(AU)

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OBJETIVO: Determinar o perfil clínico dos pacientes submetidos à reconstrução da cavidade orbitária com implante de Mules. MÉTODOS: Foi realizado um estudo epidemiológico com delineamento transversal, baseado na análise dos prontuários de pacientes submetidos à cirurgia de enucleação ou evisceração do globo ocular assistidos no Departamento de Plástica Ocular e Órbita do Hospital Regional de São José (HRSJ) entre dezembro de 1999 a dezembro de 2009. As variáveis utilizadas foram: idade, sexo, cirurgia realizada, indicação, tamanho do implante e complicações pós-operatórias associadas. RESULTADOS: A análise incidiu sob registros de 68 pacientes, com predomínio do gênero masculino (60,3%) cuja média de idade foi de 38,4 anos. Adultos jovens destacaram-se com a maior frequência de perda do globo ocular. As principais etiologias que cursaram com a enucleação ou evisceração do globo ocular foram trauma ocular, glaucoma, melanoma de coróide e phthisis bulbi. O trauma ocular apresentou maior prevalência no sexo masculino (p<0,01). As complicações pós-cirúrgicas com maior frequência foram expulsão ou extrusão do implante (20,6%) e retração de cavidade ocular (5,9%). CONCLUSÃO: As principais causas de perda do globo ocular foram trauma ocular, glaucoma, melanoma de coroide e phthisis bulbi. As complicações pós-cirúrgicas após implante de Mules foram expulsão ou extrusão do implante e retração de cavidade ocular. Os implantes de 15 e 16 mm apresentaram maior assiduidade e o tamanho da esfera não interferiu no risco de extrusão.

OBJECTIVE: To access the patient's profile after enucleation or evisceration of ocular globe using mules implant. METHODS: An epidemiological study with a cross-sectional design was conducted, based on analysis of medical records of patients who underwent enucleation or evisceration of the eyeball assisted in the Department of Ocular Plastic and Orbit of the HRSJ from December 1999 to December 2009. The variables used were age, sex, surgery, indication, size of implant and postoperative complications associated. RESULTS: A total of 68 patients were analyzed. The mean age was 38,4 years and the most prevalent genre was male (60.3%). Young adults stood out with greater frequency of loss of the eyeball. The main etiologies presenting with enucleation or evisceration of the eyeball were ocular trauma, glaucoma, choroidal melanoma and phthisis bulbi. The ocular trauma was more prevalent in males (p<0.01). The postoperative complications more frequently were expulsion or extrusion of the implant (20.6%) and retraction of the orbital cavity (5.9%). CONCLUSION: The main causes of loss of the eyeball were ocular trauma, glaucoma, choroidal melanoma and phthisis bulbi. The postoperative complications after Mules´ implant were expulsion or extrusion of the implant and retraction of the orbital cavity. The implants 15 and 16 mm showed greater frequency and the size of the ball did not affect the risk of extrusion.

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As próteses oculares são responsáveis pela recuperação da estética e auto-estima do usuário. As técnicas existentes para a confecção da prótese ocular devem resultar em íris artificiais perfeitamente estéticas com conseqüente dissimulação do defeito facial. Dessa forma, este estudo tem como propósito verificar a alteração de cor do botão de íris artificial entre diferentes técnicas após a polimerização e o envelhecimento acelerado. Foram confeccionadas 60 amostras simulando próteses oculares distribuídas em grupos (n=10) de acordo com a técnica utilizada, sendo: PE: técnica convencional sem verniz, PEV: técnica convencional com verniz, CA: técnica com calota pré-fabricada sem verniz, CAV: técnica com calota pré-fabricada com verniz, PI: técnica da pintura invertida sem verniz, PIV: técnica da pintura invertida com verniz. A leitura de cor foi realizada por meio de um espectrofotômetro de reflexão ultravioleta visível utilizando o sistema CIE L*a*b*, antes e após polimerização, e após 252, 504 e 1008 de envelhecimento acelerado. Os dados obtidos foram submetidos à análise de variância (ANOVA), e teste de Tukey (p<0,05). O teste de cor mostrou que após polimerização e envelhecimento acelerado todas as amostras apresentaram alteração significativa da cor, porém, as amostras com verniz protetor de tinta tiveram menor alteração em todos os períodos analisados

Ocular prostheses are responsible not only for the recovery of aesthetic but also for the self-esteem of the anophthalmic patient. The techniques used to fabricate ocular prosthesis should result in artificial iris with adequate aesthetic and natural appearance. When such characteristics are not achieved, the fabrication of new prosthesis is indicated even in the presence of good fit of the old prosthesis. Additionally, the color instability of iris is the most relevant factor that affects the longevity of ocular prosthesis, and is related to the polymerization process of the acrylic resin and its clinical use over time. Therefore, the present study investigated the color alteration of artificial iris buttons obtained by different techniques after polymerization and accelerated aging. A total of 60 samples simulating an ocular prosthesis were fabricated and divided into groups (n=10) according to the technique used: PE – conventional technique without varnish; PEV - conventional technique with varnish; CA - Prefabricated cap technique without varnish; CAV - Prefabricated cap technique with varnished; PI - Reverse painting technique without varnish; PIV - Reverse painting technique with varnish. Color measurements were performed by using a visible ultraviolet reflection spectrophotometer with the CIE L*a*b* system, before and after polymerization, and after 252, 504 and 1008 hours of accelerated aging. Data were submitted to analysis of variance (ANOVA) and Tukey test (p<.05). After polymerization and accelerated aging periods all samples exhibited statistically color alteration; however, the varnished samples had lower color change for all periods

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The use of ocular prostheses for ophthalmic patients aims to rebuild facial aesthetics and provide an artificial substitute to the visual organ. Natural intemperate conditions promote discoloration of artificial irides and many studies have attempted to produce irides with greater chromatic paint durability using different paint materials. OBJECTIVES: The present study evaluated the color stability of artificial irides obtained with two techniques (oil painting and digital image) and submitted to microwave polymerization. MATERIAL AND METHODS: Forty samples were fabricated simulating ocular prostheses. each sample was constituted by one disc of acrylic resin N1 and one disc of colorless acrylic resin with the iris interposed between the discs. The irides in brown and blue color were obtained by oil painting or digital image. The color stability was determined by a reflection spectrophotometer and measurements were taken before and after microwave polymerization. Statistical analysis of the techniques for reproducing artificial irides was performed by applying the normal data distribution test followed by 2-way ANOVA and Tukey HSD test (α=.05). RESULTS: Chromatic alterations occurred in all specimens and statistically significant differences were observed between the oil-painted samples and those obtained by digital imaging. There was no statistical difference between the brown and blue colors. Independently of technique, all samples suffered color alterations after microwave polymerization. CONCLUSION: The digital imaging technique for reproducing irides presented better color stability after microwave polymerization.

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El desarrollo de los implantes oculares porosos ha sido un reto para los oftalmólogos actuales al descubrir un material que no es rechazado por el organismo, evitado el riesgo de infección y exposición del implante. En este trabajo exponemos nuestra experiencia con 200 pacientes operados en nuestro centro y en los cuales empleamos implantes orbitarios de hidroxiapatita porosa coralina HAP-200 confeccionados en nuestro país, en el periodo comprendido desde 2005-2010. Los pacientes intervenidos estaban enmarcados entre las edades de 3-65 años de edad. A todos los casos le realizamos cuadrisección escleral como técnica quirúrgica de elección. En ninguno de los casos intervenidos tuvimos complicaciones y los signos y síntomas postoperatorios fueron locales y ligeros. Los resultados cosméticos evaluados así como la tolerancia al implante fueron muy satisfactorios, demostrándose la eficacia del implante como alternativa quirúrgica para estos pacientes.

The development of you implants them ocular porous it has been a challenge for the current oculists when discovering a material that is not rejected by the organism, avoided the infection risk and exhibition of the one implant. In this work we expose our experience with 200 patients operated in our center and in which we use you orbitals implant of coralline porous hidroxiapatite HAP-200 made in our country, in the period understood from 2005-2010. The intervened patients were framed among the 3-65 year-old ages. To all the cases we carry out him escleral cuadrisection like surgical technique of election. In none of the intervened cases we had complications and the signs and postoperative symptoms were local and slight. The evaluated cosmetic results as well as the tolerance to the one implants they were very satisfactory, being demonstrated the effectiveness of the one implants as surgical alternative for these patients.

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Objetivo: A correta adaptação da prótese ocular na cavidade anoftálmica é fundamental para que ocorra uma boa mobilidade da prótese ocular, aspecto primordial na dissimulação da condição artificial presente em uma prótese ocular. Este trabalho avalia comparativamente a técnica de moldagem com seringa e seringa com moldeira acrílica em um grupo de 15 pacientes submetidos à enucleação do globo ocular. Método: Os grupos de estudo, constituídos de acordo com as técnicas de moldagem, foram avaliados mediante a confecção de corpos de prova em resina acrílica de lenta polimerização para observação do diâmetro transversal, diâmetro vertical e área das moldagens. Os corpos de prova foram submetidos à captação de imagens com lupa estereoscópica e câmara digital e as imagens foram processadas no programa ImageLab 2000®. Resultados: A análise estatística Postos Sinalizados de Wilcoxon (p≤0,05) mostrou que o diâmetro transverso foi semelhante em ambas as técnicas de moldagem. O menor diâmetro vertical observado com a técnica da seringa foi estatisticamente significante (p≤0,05). A área da superfície da mucosa da cavidade anoftálmica abrangida pela moldagem foi significantemente maior na técnica de moldagem com seringa e moldeira acrílica (p≤0,05). Conclusão: A técnica de moldagem com seringa e moldeira acrílica proporciona melhor direcionamento do material de moldagem no sentido súpero-inferior, o que determina uma maior área de contato da prótese com a superfície da mucosa. Considerando que a mobilidade de uma prótese ocular é dependente de uma boa adaptação da prótese na superfície da mucosa, pode-se inferir que a técnica de moldagem com seringa e moldeira acrílica acoplada deverá favorecer a mobilidade e a estética das próteses oculares

Objective: An excellent adaptation of the ocular prosthesis to the walls of the anophthalmic socket is fundamental to attain a good mobility of the artificial eye, a primordial aspect in dissimulating the artificial aspect of the prosthesis. This study compares the direct syringe impression technique to the impression taked with syringe and acrylic stock tray in a group of 15 patients submitted to eye enucleation. Methods: The study groups were established according to the impression technique employed and evaluated by means of specimens made of heat polymerizing resin in relation to transversal diameter, vertical diameter and area. The specimens were submitted to a stereoscopic glass and the images generated by a digital camera were processed by the software ImageLab 2000®. Results: The Wilcoxon rank-signed test (p≤0.05) showed that the transversal diameter was similar in both impression techniques. However, the smaller vertical diameter provided by the direct syringe technique was statiscally significant (p≤0.05). The area of the mucous surface of the anophthalmic socket registered during the impression taken with syringe and acrylic tray was significantly larger (p≤0.05). Conclusion: The syringe and acrylic tray impression technique provides a better distribution of the impression material, mainly in the superoinferior direction, and this accounts for the larger contact of the prosthesis with the mucous surface. Considering that the mobility of the ocular prosthesis is dependent of a good adaptation of the prosthesis on the mucous surface, the syringe and acrylic tray impression technique shall improve the mobility and aesthetics of ocular prosthesis

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As próteses oculares são responsáveis pela recuperação da estética e auto-estima do usuário. Assim, os materiais utilizados na confecção de prótese ocular devem possuir propriedades específicas para sua indicação e durabilidade. Desse modo, é importante avaliar o comportamento destes materiais quando influenciados por diversas soluções desinfetantes. Este estudo teve como objetivo avaliar a microdureza, rugosidade superficial e alteração de cor de próteses oculares sobre a influência dadesinfecção química e armazenagem. Foram confeccionadas 50 amostras simulando próteses oculares contendo duas resinas acrílicas (N1 e incolor), distribuídas em cinco grupos de acordo com o desinfetante utilizado: sabão neutro (I), opti-free (II), efferdent (III), hipoclorito a 1% (IV) e clorexidina a 4% (V). As amostras foram armazenadas por 120 dias, sendo desinfetadas durante este período. As leituras de microdureza, rugosidade e cor das amostras foram realizadas em um período inicial (B) e após 60 (T1) e 120 (T2) dias de armazenagem com desinfecção. A microdureza foi mensurada por meio de um microdurômetro, e a rugosidade determinada por um rugosímetro. A leitura de cor foi realizada por meio da espectrofotometria de reflexão, usando o sistema CIE L*a*b*. A alteração de cor (ΔE) foi calculada para os períodos entre T1 e B (T1B), e T2 e B (T2B). Pelos resultados obtidos a resina N1 para esclera apresentou menor microdureza estatisticamente significante, comparada a resina incolor (P<0,05). A maior alteração dos valores de microdureza e rugosidade foi obtida para os grupos IV e V. Ambos os períodos de desinfecção e armazenagem produziram alterações significativas (P<0,05) nas amostras com diminuição dos valores de microdureza e aumento dos valores de rugosidade. Todas as íris artificiais apresentaram alteração de cor. O período T2B apresentou maiores valores de alteração de cor. Não houve diferença significante de alteração de cor das amostras entre os desinfetantes. Pode-se...

Ocular prostheses are responsible to restore not only patient’s aesthetic but also its self-esteem. The materials used to fabricate the ocular prostheses should present specific properties regarding its indication and durability. Therefore, it is important to investigate the physical behavior of such materials when subjected to different disinfectant solutions. This study evaluated the microhardness, surface roughness and color stability of ocular prostheses under the influence of different chemical disinfectant solutions and storage. A total of 50 samples simulating an ocular prosthesis containing two acrylic resins (N1 and colorless) were fabricated. They were divided into five groups as a function of disinfectant solution: neutral soap (I), opti-free (II), efferdent (III), 1% hypochlorite (IV) and 4% chlorhexidine (V). Samples were storage during 120 days, and they were disinfected throughout the period. Microhardness, roughness and color measurements were performed at baseline (B), after 60 (T1) and 120 (T2) days of storage with disinfection. The microharness and the roughness measurements were evaluated using a microdurometer and a roughness meter, respectively. Samples colors were measured with spectrophotometer using CIE L*a*b* system. Color differences (ΔE*) were calculated for periods between T1 and B (T1B), and T2 and B (T2B). The N1 acrylic resin exhibited statistically lower microhardness when compared to the colorless acrylic resin (P<0.05). The highest microhardness and roughness alterations were observed for groups IV and V. Both disinfection and storage periods statistically reduced the microhadness values and increased the roughness values of the samples (P<0.05). Color alteration was observed in all artificial irises. No statistical significant difference on color stability of the samples was observed among the disinfectants. It was concluded that the microharness and surface roughness values of the samples were within acceptable clinical...

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The purpose of this study was to assess color alteration of the paints used for iris painting in artificial eyes. Five disks of heat cured acrylic resin were confectioned by microwave energy for each paint analyzed, in a total of 40 specimens. Each specimen consisted of a colorless acrylic resin disk and another of equal size, of scleral white colored acrylic resin, with the painting interposed between the two disks. The specimens were submitted to an accelerated aging process in a chamber under ultraviolet radiation for 1,008 hours. To assess color variation, a reflective spectrophotometer was used. The results were statistically analyzed by ANOVA and the Tukey test (p < 0.05). All the paints underwent chromatic alteration. The oil paint presented the highest resistance to accelerated aging.

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Prosthetic eyes are artificial substitutes for the eyeball, made of heat-curing acrylic resin, serving to improve the esthetic appearance of the mutilated patient and his/her inclusion in society. The aim of this study was to assess the flexural strength of two heat-curing acrylic resins used for manufacturing prosthetic eyes. Thirty-six specimens measuring 64 x 10 x 3.3 mm were obtained and divided into four groups: acrylic resin for artificial sclera N1 (Artigos Odontológicos Clássico, São Paulo, SP, Brazil), heat-cure water technique (GI) and microwave-cured (GII); colorless acrylic resin for prosthetic eyes (Artigos Odontológicos Clássico, São Paulo, SP, Brazil), heat-cure water technique (GIII) and microwave-cured (GIV). Mechanical tests using three point loads were performed in a test machine (EMIC, São José dos Pinhais, PR, Brazil). The analysis of variance and the Tukey test were used to identify significant differences (p < 0.01). Groups GII and GIV presented, respectively, the highest (98.70 ± 11.90 MPa) and lowest means (71.07 ± 8.93 MPa), with a statistically significant difference. The cure method used for the prosthetic eye resins did not interfere in their flexural strength. It was concluded that all the resins assessed presented sufficient flexural strength values to be recommended for the manufacture of prosthetic eyes.

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