Improved prosthetic motility with placement of a second coupling PEG

Area of Science:

• Ophthalmology
• Ocular Prosthetics
• Reconstructive Surgery

Background:

• Integrated coupled orbital implants enhance prosthetic motility compared to noncoupled designs.
• Anophthalmic patients may experience limited prosthetic motility due to factors like forniceal scarring or implant issues.
• Improving prosthetic motility is crucial for anophthalmic rehabilitation.

Purpose of the Study:

• To evaluate the efficacy of placing a second coupling peg in anophthalmic patients with limited prosthetic motility despite an integrated coupled orbital implant.
• To address limitations in prosthetic motility caused by conjunctival scarring, implant rotation, or forniceal contracture.

Main Methods:

• Six anophthalmic patients with poor prosthetic motility despite excellent implant motility were selected.
• Patients had prior hydroxyapatite implants and motility peg placement.
• A second titanium motility peg was placed after assessing implant vascularization and motility limitation direction.

Main Results:

• All six patients demonstrated improved prosthetic motility after the second coupling peg placement.
• Improvements were noted by both patients and surgeons.
• No surgical complications were reported.

Conclusions:

• Placement of a second motility coupling peg is a viable option for select anophthalmic patients experiencing poor prosthetic motility.
• This intervention can effectively improve the translation of implant motility to prosthesis motility.