BACKGROUND: One of the purposes of ocular prosthetics is to prevent the progression of pathological processes in the eyelids and conjunctiva of the anophthalmic socket. AIM: The aim of this study is to assess the effectiveness of therapeutic eyelid hygiene products: Blepharowipe, Blepharogel cleansing (Geltek-Medica, Russia), used in the late postoperative and long-term rehabilitation periods, in patients with anophthalmia who lost the eyeball as a result of an injury. MATERIALS AND METHODS: For the study, 3 main (50 patients) and 3 corresponding control groups (50 patients) were created. The examination of patients included: complaints, medical history; biomicroscopy of the eyelids, the conjunctiva of the anophthalmic socket, and the surface of the ocular prosthesis. In the main groups, therapeutic eyelid hygiene products were used for 8 weeks in combination with regular ocular prosthesis care. In the control groups, eyelid hygiene products were not used. Assessment and analysis of the effectiveness of the products was carried out after 1, 2 and 4 weeks in group I and after 4 and 8 weeks in groups II and III based on the dynamics of patient complaints and objective examination indicators. RESULTS: In the main groups I and II, there was a positive dynamics: normalization of the state of the eyelids and the conjunctiva of the anophthalmic socket; increasing comfort of an ocular prosthesis wear. In the main group III and in all control groups, no significant positive dynamics was noted. CONCLUSIONS: The results of using the products included in the course of therapeutic hygiene of the eyelids: Blepharowipe, Blepharogel cleansing showed high efficiency, and give reason to recommend them in late postoperative and long-term rehabilitation periods in patients with anophthalmia.
Aim. To determine the optimal shape of the locomotor stump and the configuration of the corresponding ocular prosthesis, ensuring their maximum motility in patients with anophthalmia with different methods of eye removal. Materials and methods. The study group consisted of 132 patients aged 1880 years after enucleation or evisceration. Examination methods included medical history; examination of eyelids, measurement of length and width of the palpebral fissure, as well as of the depth of conjunctival fornices on both sides; assessment of the volume, shape, surface topography, position and excursions of the locomotor stump, of the protrusion of the ocular prosthesis compared to the contralateral eye; photo registration of the studied parameters. Results. During the study, there were 3 types of locomotor stump identified: moderate with retraction in the upper third; voluminous flattened; voluminous hemispherical. The locomotor stump after enucleation was voluminous flattened or moderate with retraction in the upper third. The best motility of the locomotor stump was noted nasally and downward. The motility of the ocular prosthesis was 47.4% compared to the contralateral eye. The locomotor stump after evisceration with keratectomy was voluminous hemispherical or voluminous flattened. Its motility in all four directions was about the same. The motility of the ocular prosthesis in comparison to the contralateral eye was 55.9%. The locomotor stump after evisceration without keratectomy was voluminous hemispherical, uniform, smooth. The motility of the locomotor stump was maximal in comparison to other groups and relatively equal in all four directions. The motility of the ocular prosthesis in comparison to the contralateral eye was 68.2%. Conclusion. The optimal shape of the locomotor stump, providing the greatest motility of the ocular prosthesis is voluminous hemispherical. The same protrusion of the eyeball and that of the cosmetic prosthesis relatively to the frontal plane after enucleation is achieved by increasing the thickness of the prosthesis itself, which reduces its motility. Evisceration with implantation of the orbital prosthesis involves the use of a thin-walled ocular prosthesis, the back surface of which ideally repeats the locomotor stump surface and does not prevent its maximum motility. When removing a squinting eyeball with preserved corneal diameter, a smaller implant should be used to prevent excessive opening of the palpebral fissure, or to prefer evisceration with keratectomy.
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