Scleral Epitheses

They are indicated for enucleated or eviscerated patients with primary implant with cavities that require little volume or cases of Ptisis bulbi. Its thickness is approximately from 0.5 to 1 mm. They differ in that they are more concave. They are made from an exact mold of the patient’s eyeball; we carry out this process with great care because it is essential that the future epithesis has a uniform pressure along the eyeball to achieve the maximum centering effect and so that the palpebral openings are correct. Scleral epitheses are custom-made in an acrylic resin material approved for medical use according to European directives.

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Use and Maintenance

  1. Wash your hands before handling the epithesis.
  2. At night, remove the epithesis from the eye.
  3. Pour a few drops of cleanser into the palm of your hand and rub the epithesis for 10-20 seconds.
  4. Rinse thoroughly with the sterile solution.
  5. Store the epithesis in the case and add fresh saline solution.
  6. If the corneal epithesis is soft (hydrophilic), it should be disinfected regularly, using either of the two options below:
    • The case should be boiled every three days:
      1. Put fresh sterile solution in the case
      2. Put the lenses on and close the case
      3. Add water to a saucepan, about 200 ml
      4. Heat the saucepan until the water boils
      5. Insert the case and wait about 20 minutes
    • Use any commercially available soft contact lens peroxide system.

Precautions

  1. Before changing maintenance solutions, consult your specialist.
  2. Do not expose directly to the sun
  3. In case of soft or hydrophilic epitheses: If they dry in the case, add sterile saline solution and wait 30 minutes. Polyhexamethylenebiguanide or Hexetidine or Biguanide as they may discolour the cornea epithesis.
  4. Do NOT use a single solution with a soft disinfectant.
  5. In case of discomfort or redness of the eye stop using the epithesis and consult your specialist.
  6. The estimated duration of a corneal epithesis, except in specific cases, is two years. It is recommendable to go for a minimum review every year and it will be your specialist who dictates the state of your corneal epithesis.

Cases

In the case of scleral epitheses, it is essential that the prosthesis does not rotate. Being thin and hollow, the epithesis has a natural tendency to rotate. In this case, the cavity has volume and we are in the thin border that separates an entire prosthesis from a scleral epithesis.

Cases resolved with scleral epithesis, the majority of cases correspond to Ptsis bulbi, atrophied eyes generally due to traumatisms.
We also include two cases of eviscerations with implant that, due to volume, were resolved with scleral prostheses.