Name: customizing a cryolite glass prosthetic eye
Uploaded: 2019-10-31T12:30:00
Description: Watch this Scientific Journal Video about Customizing a Cryolite Glass Prosthetic Eye at JoVE.com

No funding was received for this manuscript.

All procedures performed in the following protocol involving human participants were in accordance with the ethical standards of the institutional research committee of the University of Cologne and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.
1. Prosthetic eye customization
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	<li>Select one of the &#34;half-done&#34; cryolite glass eyes based on the best matching iris color to the healthy fellow eye of the patient (<strong class="...

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R., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Ocular+prosthetics.+Fitting,+daily+use+and+complications.">Ocular prosthetics. Fitting, daily use and complications.</a> Ophthalmologe. 113 (2), 133-142 (2016).</li><li>Pine, K. R., Sloan, B. H., Jacobs, R. J. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=.">.</a> Clinical ocular prosthetics. 1st ed. , (2015).</li><li>Buckel, M., Bovet, J. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=The+eye+as+an+art+form:+the+ocular+prosthesis.">The eye as an art form: the ocular prosthesis.</a> Klinische Monatsbl&#228;tter Augenheilkunde. 200 (5), 594-595 (1992).</li><li>Rokohl, A. 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J. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=A+proposed+model+of+the+response+of+the+anophthalmic+socket+to+prosthetic+eye+wear+and+its+application+to+the+management+of+mucoid+discharge.">A proposed model of the response of the anophthalmic socket to prosthetic eye wear and its application to the management of mucoid discharge.</a> Medical Hypotheses. 81 (2), 300-305 (2013).</li><li>Pine, N. S., de Terte, I., Pine, K. R. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=An+investigation+into+discharge,+visual+perception,+and+appearance+concerns+of+prosthetic+eye+wearers.">An investigation into discharge, visual perception, and appearance concerns of prosthetic eye wearers.</a> Orbit. 36 (6), 401-406 (2017).</li><li>Pine, K. R., Sloan, B., Jacobs, R. 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Following enucleation with an orbital implant, a conformer has to be inserted for two weeks (Figure 1) in order to prevent scarring of the conjunctival fornices and subsequent inserting of a prosthesis2,3,4,7,12,13. Because an early ocular prosthesis insertion improves quality of life after enucl...

The purpose of the present manuscript is to comprehensively demonstrate the technique of manufacturing a customized cryolite glass prosthetic that is long forgotten outside the German-speaking countries (Figure 1). This manuscript also focuses on major advantages of this technique. These include a very smooth surface of the prosthesis due to fire polishing, the light weight of the prosthesis due to the hollow design, high levels of patient satisfaction, and the need of only one appointment for manufacturing of the customized prosthesis1,2,3,4,5. This article also gives ophthalmologists better insights into ocularistic care in order to improve essential interprofessional collaboration1,2,3,4,5.
In 1832, the glassblower Ludwig Uri M&#252;ller from Thuringia, Germany, developed the cryolite glass prosthetic eye based on the class-leading models made in France4. Benefits of cryolite glass included a better look, better tolerability, easier processing, and longer durability than previous glass eyes4,6,7,8. Herman Snellen, a Dutch eye surgeon, used this cryolite glass to produce a lightweight hollow prosthetic eye in 18804,6,7,8. This lightweight prosthetic eye, the Snellen &#8216;reform eye&#8217;, increased the volume of prosthetic eyes, resulting in better fitting into larger eye sockets following the introduction of enucleation procedures made possible by the development of anesthesia and asepsis4,8. Twenty years later, cryolite glass had become the most commonly used material for prosthetic eyes. Germany developed into the manufacturing center of prosthetic eyes globally2,4,5,7,8. At the start of the second world war, German cryolite glass eyes became unavailable outside of the German-speaking area. Therefore, (poly)methyl methacrylate (PMMA) became a substitute material for prosthetic eyes4,7,8, and today PMMA is the most commonly used material for prosthetic eyes globally4,5,8. Notwithstanding, in German speaking countries, over 90% of ocularists still manufacture customized prostheses using the cryolite glass from Thuringia2,3,4,5,7,8,9,10,11,12,13. Each customized cryolite glass prosthetic eye is produced in two major steps: the first step is to produce a &#34;half-done&#34; cryolite glass eye that conforms to a white sphere with an iris and a pupil (Figure 2). The second and decisive step is to customize the &#34;half-done&#34; cryolite glass prosthetic eye for the respective patient. To that end, a &#34;half-done&#34; cryolite glass eye is selected from thousands (Figure 3) based on the best matching iris color to the patient&#39;s healthy fellow eye.
The following protocol presents customizing a selected &#34;half-done&#34; cryolite glass eye for a specific patient. This step lasts about 25&#8211;35 min.

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			<td height="21" style="height:21px;width:697px;">Bunsen burner with gas and air flow over a fire-resistant worktop made from anodised stainless steel</td>
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			<td height="21" style="height:21px;">Hollow skewer</td>
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			<td height="21" style="height:21px;">Ocularist forceps</td>
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			<td height="21" style="height:21px;">Preheated metal container to 500 degree celsius</td>
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			<td height="21" style="height:21px;">Pre-produced &#34;half-done&#34; cryolite glass eye</td>
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			<td height="21" style="height:21px;">Transparent glass stem</td>
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			<td height="21" style="height:21px;">Various preproduced glass stems in different colors</td>
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customizing a cryolite glass prosthetic eye

In Germany, Austria, and Switzerland, over 90% of ocularists still manufacture customized prostheses using cryolite glass from Thuringia. The present manuscript demonstrates this long-forgotten technique in detail. This manuscript shows some major advantages of manufacturing prosthetic eyes using cryolite glass in comparison to poly(methyl methacrylate) (PMMA). These advantages include a lighter weight of the prosthesis, higher levels of patient satisfaction, and only one appointment necessary for the customized manufacturing. Potential risk of breakage seems not to be a critical disadvantage for glass prosthetic eye wearers. However, in some patients, manufacturing a well-fitting prosthetic eye is not possible or reasonable due to anophthalmic socket complications such as post nucleation socket syndrome, scarred fornices, or an orbital implant exposure. This article gives ophthalmologists a better insight into ocularistic care in order to improve the essential interprofessional collaboration between ocularists and ophthalmologists.

Optimal results include a new prosthetic cryolite glass eye that fits very well, is comfortable, has a good motility, and the appearance with the prosthetic eye, including the eye lid contour, is nearly symmetrical to the healthy fellow eye (Figure 12).
Suboptimal results can result if the new prosthetic cryolite glass eye fits and is comfortable, but there are concerns regarding the cosmetic results. If a prosthesis does not fit perfectly, the appearance, includi...

Watch this Scientific Journal Video about Customizing a Cryolite Glass Prosthetic Eye at JoVE.com

Customizing a Cryolite Glass Prosthetic Eye

This manuscript shows each step of customizing a cryolite glass prosthetic eye including some major advantages of the use of cryolite glass for manufacturing an eye prosthesis compared to poly(methyl methacrylate). In addition, this manuscript gives ophthalmologists better insight into the ocularistic care that could improve interprofessional collaboration.

In Germany, Austria, and Switzerland, over 90% of ocularists still manufacture customized prostheses using cryolite glass from Thuringia. The present ...

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