A new, personalised and non-invasive treatment using 3-D printed implants has been developed to help children born with abnormally small or missing eyes (microphthalmia/anophthalmia, or MICA). The research was presented at the 2017 Annual Meeting of the Association for Research in Vision and Ophthalmology (ARVO) in Baltimore, USA.
The 3-D biocompatible implants, known as conformers, were well-tolerated and found to non-invasively stimulate eye socket expansion and eyelid opening growth. Without eye socket growth, further facial deformities can occur with age. While there is no treatment that will create a new, functioning eye, fitting with a prosthetic (artificial) eye for cosmetic purposes requires sufficient eye socket volume. The treatment resulted in eye cavity volumes that were on average 35 per cent of reference eye volumes (corrected for age) whereas no treatment would have resulted in only 7.6 per cent.
In the study cohort, four babies received the first in a series of eye orbit conformers, following MRIs and the creation of impression moulds. A set of conformers of increasing size was given to the parents, who were taught to replace the conformer for a larger one as soon as it would fit into the eye socket.
Currently ocularists work closely with an ophthalmologist and oculoplastic surgeon to make conformers and prosthetic eyes for children born with abnormally small or missing eyes. A conformer is a plastic shelllike device that is placed inside the orbit to help support the growth of the eye socket and the bones in the face. As the child grows, and the orbits and facial bones develop, a prosthetic eye replaces the conformer. Both prosthetic eyes and conformers need to be changed regularly in infants to support their growth. The process of creating the conformer and prosthetic eyes has been described as “laborious” and “as much artwork as it is medical care”.1
The process of creating the conformer and prosthetic eyes has been described as “laborious” and “as much artwork as it is medical care
Dr. Irene Gottlob, a professor of ophthalmology at the University of Leicester Ulverscroft Eye Unit (who was not involved in the study), told Live Science.1 “This is certainly a novel approach with several advantages…This is a good example of individualised treatment, or ‘precision medicine.’ It is also a good example of how 3D printing can be used in medicine.”
Dr. Gottlob said she was encouraged by the researchers’ plan to improve mathematical models to better predict eye-socket growth and development and noted that better refinement of ultrasound scans could help bring the method to younger infants, before they reach the age when they can safely undergo an MRI scan.
“I think this is a very promising … method, but experience with more patients and further development will improve this even further,” she told Live Science.
The abstract title is Personalized 3D-printed conformers for the treatment of severe microphthalmia/ anophthalmia.