Customized Silicone Ocular Prosthesis for Post-exenteration Rehabilitation: A Case Report

Ocular loss due to malignancies, trauma, or congenital anomalies can lead to significant aesthetic and psychological challenges. Orbital exenteration, a radical surgical procedure involving the removal of the eye and surrounding structures, leaves patients with severe facial deformities, impairing their self-esteem and social interactions. Prosthetic rehabilitation plays a vital role in restoring facial symmetry and improving the quality of life for such individuals. This case report presents the prosthetic rehabilitation of a 57-year-old male patient who underwent orbital exenteration due to squamous cell carcinoma. Despite undergoing surgery in 2009, the patient was not referred for a prosthetic solution at the time, leading to years of social withdrawal and psychological distress. Upon referral to the Department of Prosthodontics, various treatment options were discussed, and a custom silicone ocular prosthesis was chosen based on the patient's preference for an economical and non-invasive solution. The fabrication process involved a systematic approach, starting with primary and secondary impressions to accurately capture the anatomic contours of the defect. A wax pattern was created for trial fitting and aesthetic evaluation, ensuring a close match with the patient's natural eye. The final prosthesis was processed using room-temperature vulcanized silicone, which provided superior aesthetics, flexibility, and comfort. The prosthesis was designed to be retained using natural anatomical undercuts, eliminating the need for adhesives or external support. The patient exhibited significant psychological and social improvement following prosthesis insertion. The custom ocular prosthesis successfully restored facial aesthetics, improved self-confidence, and facilitated social reintegration. This case underscores the importance of early prosthetic referral and highlights the impact of a multidisciplinary approach in post-exenteration rehabilitation, ensuring optimal functional and aesthetic outcomes for patients with orbital defects.