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Halting the Insecure Eyeball

t ranks high on the list of ultimate embarrassments and is something that should never happen, says otolaryngologist Mark Brown, M.D., but it does. Occasionally, a patient who’s lost an eye to disease or trauma has the prosthetic eyeball come loose in a public place.

When Brown, and Steven G. Ashman, D.D.S., began using titanium implants to anchor prosthetic teeth for their patients with mandibular bone grafts, they quickly saw other applications for the procedure.

One such use, securing prosthetic eyeballs, has come into its own in Europe and has just gotten FDA approval here. So recently, the physicians with Hopkins’ oral and maxillofacial surgery services began using endosseous implants in eye sockets, says Ashman, “with considerable success. The result is a more secure prosthesis with a far more natural look.”

In a short operation, the physicians affix the implants to the bony orbit of the missing eye. Then, an anaplastologist sculpts a prosthesis that matches the patient’s healthy eye. Part of the prosthesis is shaped to fit—like a snap—into the orbital implant, and once in place, it neither rotates nor falls out, though it can be removed for cleaning. This, says Brown, is a vast improvement over the traditional prosthesis, which typically is glued in place.