Precision in Prosthetics: Two Case Reports on Transformative Rehabilitation With Custom Ocular and Orbital Prostheses.
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The eyes play a crucial role in vision and emotional expression, and their loss can profoundly affect appearance and psychological well-being. Eye loss may result from trauma, tumors, infections, malignancies, or congenital abnormalities. Surgical methods for removing an eye include enucleation, evisceration, and exenteration. When surgical reconstruction is insufficient, prosthetic rehabilitation becomes necessary, requiring collaboration among ophthalmologists, oral and maxillofacial surgeons, and prosthodontists. Ocular and orbital prostheses, which may be either prefabricated or custom-made, help maintain hygiene and monitor for tumor recurrence, significantly improving the patient's quality of life. We report two cases that describe a technique for fabricating a custom ocular and silicone-based orbital prosthesis, particularly useful for patients with defects caused by tumors or trauma. One case involved a five-year-old boy who sought treatment for an ocular prosthesis after enucleation of his left eye due to retinoblastoma. A custom prosthesis was crafted to accommodate the child's facial growth, and follow-up visits indicated positive aesthetic and psychological outcomes. Another case involved a 54-year-old man who had undergone exenteration of his left eye eight years prior due to low-grade myxofibrosarcoma. Extensive preoperative planning and patient counseling were undertaken, and a custom magnet-retained silicone-based orbital prosthesis was designed to match his facial features. Multiple adjustments were made for comfort and functionality, and the patient reported significant improvements in social interactions and self-esteem. These cases underscore the importance of personalized care and teamwork in prosthetic rehabilitation. For many years, artificial eyes have been replaced with either stock or custom prostheses, with custom options generally providing a more accurate and aesthetically pleasing result, especially in patients who have undergone enucleation or exenteration. While implant-retained prostheses can enhance outcomes, conventional ocular and orbital prostheses remain practical, cost-effective options that support psychosocial well-being, even though they do not restore vision. In pediatric cases, it is critical to regularly adjust the prosthesis to accommodate the child's growth and prevent complications. Room temperature vulcanized (RTV) silicone is favored for its flexibility and compatibility, though it requires routine maintenance due to wear and discoloration. Samarium-cobalt magnets, commonly used for retention, offer strong stability but can corrode over time, necessitating encapsulation and regular inspections. Despite some limitations, traditional prostheses are highly effective in ocular rehabilitation, and advances in computer-aided designing-computer-aided manufacturing (CAD-CAM) technology now offer enhanced solutions for addressing such defects. Rehabilitating defects with custom prostheses is a transformative process, significantly improving patients' lives. By restoring natural appearance and function, these prostheses not only enhance physical aesthetics but also boost emotional well-being and social confidence. The precise creation and fitting of these custom devices ensure a perfect match, leading to greater comfort and patient satisfaction.