|LETTER TO THE EDITOR
|Year : 2015 | Volume
| Issue : 4 | Page : 1047
Orbital retinoblastoma: Prosthetic frontier
Himanshi Aggarwal, Pradeep Kumar
Department of Prosthodontics, Faculty of Dental Sciences, King George's Medical University, Lucknow, Uttar Pradesh, India
|Date of Web Publication||15-Feb-2016|
Department of Prosthodontics, Room No. 404, E Block, Gautam Buddha Hostel, King George's Medical University, Lucknow, Uttar Pradesh
Source of Support: None, Conflict of Interest: None
|How to cite this article:|
Aggarwal H, Kumar P. Orbital retinoblastoma: Prosthetic frontier. J Can Res Ther 2015;11:1047
I read with much interest an article entitled “Orbital Retinoblastoma: Where do we go from here?” It's a very well written and comprehensive review article covering various frontiers to be dealt with while confronting retinoblastoma. Being actively involved in the prosthetic rehabilitation of children with retinoblastoma, I would like to add one more frontier, i.e. Prosthetic Frontier. The treatment of retinoblastoma does not end with enucleation or exenteration; an equally important aspect is the prosthetic rehabilitation of these patients, so as to help them reintegrate in today's esthetic conscious society, thereby improving their quality of life.
As mentioned by Ali et al. that newer orbital implants, materials and techniques with less complications and newer modalities of socket reconstruction are coming up in the field of ocularistry and oculoplasty; a point worth mentioning is that all the efforts and benefits of an orbital implant and socket reconstruction may go futile if early placement of post-surgical conformer or an ocular prosthesis is not done. What the patient wants is an eye, not an orbital implant. The need of an early prosthetic rehabilitation cannot be undermined, if future complications such as post-enucleation socket syndrome or facial asymmetry are to be avoided.
Hitherto, glass and acrylic eyes were commonly fabricated. But, with the advent of silicone, a more lifelike prosthesis can be made. To add to the liveliness of an artificial eye, a photodynamic iris that utilizes liquid crystal display technology instead of a static iris, which shows no light reactive pupillary dimension variation, may be incorporated in the prosthesis. In cases of exenteration, previously medical adhesives or spectacle were used for retention of orbital prosthesis. Now days, these are considered to be obsolete and surgeons prefer to place implants in the superior and lateral orbital bony rim to provide a stable and more retentive means of securing the prosthesis. Today's anophthalmic patient doesn't need to bother about his appearance nor has to be conscious about his prosthesis falling off.
Although a precisely fabricated prosthesis alleviates the psychological and the social distress, still the main purpose of having an eye that is the vision cannot be returned to these unfortunate children. However, the ray of hope is still enlightened within me that we are not far away from that auspicious day when advances in stem cells and tissue engineering technology will make eye regeneration and transplantation a reality. Until then, the prosthetic frontier should not be disregarded.
| > References|| |
Ali MJ, Reddy VA, Honavar SG, Naik M. Orbital retinoblastoma: Where do we go from here? J Cancer Res Ther 2011;7:11-4.
Tummawanit S, Shrestha B, Thaworanunta S, Srithavaj T. Late effects of orbital enucleation and radiation on maxillofacial prosthetic rehabilitation: A clinical report. J Prosthet Dent 2013;109:291-5.
Aggarwal H, Kumar P. Surgical reconstruction or prosthetic rehabilitation following orbital exenteration: A clinician's dilemma Indian J Plast Surg 2014;47:146-7.
Lapointe J, Durette JF, Harhira A, Shaat A, Boulos PR, Kashyap R. A 'living' prosthetic iris. Eye (Lond) 2010;24:1716-23.