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Ancient and contemporary history of artificial eyes.

Throughout history, the human eye has been mentioned by authors as the most precious of gifts. It unveils the entire outer world to our consciousness, gives life expression and dignity to the face. The loss of an eye must therefore have always been regarded as the greatest misfortune. The ancient cultures of Babylon, Jericho, and Egypt used "art-eyes" in mummies, sarcophagus lids, and statues; they were made from precious stones, silver, gold, and copper as a symbol of light and life in their religious beliefs. Most of the recorded sources concerning the ancient practice of medicine were among the scrolls contained in the library of Alexandria. In the period between the Roman Colonial wars, the rise of Christianity and the fall of Alexandria to Arabs in 642 A.D., almost all of these sources, including those concerning the practice of Ophthalmology were lost. The largest collection of antiquity "art-eyes" and artificial eyes, mentioned in this paper, are found in the collection of the firm of Mueller and Sohne, Wiesbaden, Germany. They include the progress made in human artificial eyes to modern times. Historically, man has tried to alleviate the psychological suffering incurred by the loss of an eye, by hiding or covering the defacement with a patch. Of greater significance are the efforts made by the ophthalmologist and the ocularist (past and present) to restore functionally and cosmetically the natural facial appearance by means of an ocular prosthesis that corresponds to the remaining natural eye. Associated problems frequently concern both the reconstructive surgeon, who must be informed of the ocular prosthetic possibilities that are within the capacity of the ocularist, and the ocularist, who must create the prosthesis.

Eye, Artificial↗

Myelination in rabbit optic nerves is accelerated by artificial eye opening.

Artificial opening of the eyes of young rabbits on the 5th postnatal day led to accelerated myelination: the myelin-specific basic and proteolipid proteins nearly doubled between the 7th and the 10th postnatal days when compared to controls; 2',3'-cyclic nucleotide 3'-phosphodiesterase (CNP) activity also increased by about 60%. Conversely, lowered AChE activities presumably reflected elevated myelin/axolemma ratios. Myelination in treated animals normalized during later ontogenetic stages (greater than 20th postnatal day).

2',3'-Cyclic-Nucleotide Phosphodiesterases↗

The history of the artificial eye.

The history of the artificial eye, from antiquity to the present, is described. Around the beginning of the nineteenth century, glass eyes replaced the earlier metal ones--not always well tolerated. In 1835, cryolite glass was used instead of lead glass; to this day it remains the lightest and most desirable substance for making artificial eyes.

Eye, Artificial↗

Comparison of artificial eye amplitudes with acrylic and hydroxyapatite spherical enucleation implants.

PURPOSE: To compare artificial eye amplitudes in patients who randomly received either a hydroxyapatite or an acrylic, scleral-covered spherical implant after enucleation. DESIGN: Randomized, controlled trial. PARTICIPANTS: Thirty-four consecutive patients who underwent enucleation because of an intraocular melanoma and 21 healthy control participants from the hospital staff. METHODS: Eligible patients randomly received a hydroxyapatite or an acrylic, scleral-covered spherical orbital implant. Fourteen patients were fitted with a hydroxyapatite implant, and 16 were fitted with an acrylic implant. We measured horizontal and vertical saccadic amplitudes of both the artificial eye and the healthy eye. Measurements were performed with the magnetic search coils technique. Saccadic amplitudes of the artificial eye were compared with the healthy eye of the patient. The amplitudes of the healthy eyes were compared with saccadic amplitudes of control participants. The interval from surgery to measurements was at least 3 months in all patients. Saccadic gain (artificial eye and eye amplitude divided by target amplitude) and saccadic symmetry (artificial eye amplitude divided by healthy eye amplitude) were calculated. MAIN OUTCOME MEASURES: Saccadic gain and saccadic symmetry. RESULTS: The gain in the healthy eyes of the patients was comparable with the gain of the control eyes. Saccadic symmetry was 1.0 in control participants. In patients, it was 0.334 in horizontal saccades and 0.577 in vertical saccades. However, saccadic symmetry did not differ significantly between the acrylic group and the hydroxyapatite group (P: > 0.1 for any saccadic direction). Equivalence was detectable with a power more than 90% for horizontal saccades and more than 80% for vertical saccades. Curvilinearity was rejected for both patient groups and for all saccadic directions (P: > 0.5). CONCLUSIONS: When no motility peg is placed, acrylic and hydroxyapatite spherical implants yield comparable saccadic amplitudes of the artificial eye. Artificial eye amplitudes were markedly more restricted horizontally than vertically. In all saccadic directions, the relation between target amplitude and artificial eye amplitude was linear.

Acrylic Resins↗

Usefulness of palatal mucoperiosteal grafts for artificial eye socket contracture.

The authors performed palatal mucoperiosteal grafting for contracture of the artificial eye socket in 4 patients. Mucoperiosteal grafts were collected from the paramedian area of the hard palate. After release of contracture, the grafts were sutured with absorbable thread to the defective areas on the conjunctival side of the artificial eye socket after release of contracture. All patients showed mucoperiosteal graft survival without problems, no recurrence of contracture, and good courses of artificial eye wear. The mucoperiosteal donor areas showed closed healing after 3 to 4 weeks. Palatal mucoperiosteal grafts can be collected en bloc and are relatively rigid, which allows the simultaneous reconstruction of the conjunctival side and supportive tissue of the eyelid. Although the size of graft collection is limited, grafts with adequate size for partial reconstruction can be collected. Mucoperiosteal grafts are a good reconstruction material for contracture of the artificial eye socket.

Aged↗

Nd:YAG laser shock waves in artificial eyes.

Nd:YAG laser surgery is performed by inducing optical breakdown in the interior of the eye. The optical breakdown is accompanied by shock waves which expand throughout the entire eye. In our experiments, we measured the amplitudes of shock waves at the walls of artificial eyes caused by single and multiple pulses of optical energy originating from an Nd:YAG laser at a wavelength of 1.064 micron. We have shown that the effects observed are not caused by mechanical resonance. We believe that similar results can be expected for human eyes. The peak pulse amplitudes in artificial eyes of different length were found to increase linearly as a function of the energy transferred into the eye. The peak amplitudes of pulse sequences were found to be only half of those for single pulses of comparable energy. In laser surgery, such sequences can be preferable if they achieve the same effect.

Energy Transfer↗

Artificial eyes and tear measurements.

Ninety-four consecutive persons with unilateral enucleations or eviscerations were tested by the Schirmer I and Schirmer II tests for tear production. The findings on the artificial eye were compared with those on the companion, living (control) eye. The collected data were subjected to statistical analysis. The control eyes were shown to respond in the normal manner, more tears without topical anesthetic than with it. The sockets of artificial eyes produced no more tears without anesthetic than with it. The control eyes produced a normal amount of reflex tears, whereas the sockets of many artificial eyes produced practically no reflex tears. Tear production in persons with no complaints was compared to those with noteworthy problems. Persons with problems had only half as much basic tear secretion as those without problems. Elimination of the stimulus to reflex tear production by removal of the cornea and by the presence of the prosthesis is suggested as the cause of dryness of the eye socket. The potential value of aqueous or oily artificial lubricants is mentioned.

Adolescent↗