[Rehabilitation of Anophthalmic Patients with Prosthetic Eyes in Germany Today - Supply Possibilities, Daily Use, Complications and Psychological Aspects]. / Augenprothetische Rehabilitation in Deutschland heute ­ Versorgungsmöglichkeiten, Handhabung, Komplikationen und psychologische Aspekte.

ABSTRACT

BACKGROUND: A smooth supply with a visually appealing prosthetic eye after enucleation is not just a cosmetic solution, it is also a key factor in successful social and psychological rehabilitation. OBJECTIVES: This article provides an overview of the current state of medical and ocular care regarding prosthetic eyes in Germany. It focuses mainly on the newest clinical results, daily care, complications, and psychological aspects of wearing prosthetic eyes. METHODS: The study is comprised of the newest clinical results and a current PubMed literature review. RESULTS: In Germany, enucleated patients normally get a double-walled, hollow prosthetic eye made of cryolite glass, and patients with a microphthalmic or phthisic eye receive a thin single-walled prosthesis. Anophthalmic patients wearing cryolite glass prosthetic eyes seem to be more satisfied with their appearance and the look of their prostheses than polymethylmethacrylate (PMMA) prosthetic eye wearers. Cryolite glass prosthetic eyes must be renewed at least each year, while PMMA prostheses need to be polished once a year and renewed after five years of wearing. Among children, the fit of the prosthetic eye must be checked, based on growth, semi-annually. A slightly higher risk of breakage of cryolite glass prostheses is, for most patients, not a great disadvantage in everyday life. Ocularists and ophthalmologists should determine an individual cleaning regime, together with the patient, that is dependent on the material of the ocular prosthesis and other external factors. Complications, such as allergic, giant papillary, viral and bacterial conjunctivitis and blepharoconjunctivitis sicca must be treated at an early stage to allow for a prosthetic eye. In the case of inflammation-caused socket shrinkage or post-enucleation socket syndrome, surgical interventions are needed to re-enable the use of a prosthetic eye. Since the health of the remaining eye is the major psychological burden of prosthetic eye wearers, good ophthalmological care and medical screenings are essential elements. CONCLUSIONS: A smooth supply with a prosthetic eye, adequate and early treatment of possible complications and attention to psychological aspects is essential for successful long-term rehabilitation of enucleated patients.