Motility of the Ocular Prosthesis in Anophthalmic Patients: Objective and Patient-perceived Findings.

Aim: To study the impact of the prosthesis motility on the Quality of Life (QoL) in anophthalmic patients.

Methods: Cross-sectional, observational study of 100 anophthalmic patients, of whom 64% had an acryl implant, 6% an Allen implant, 1% a hydroxyapatite implant, 4% a dermis fat graft, 16% no implant, and 9% an unknown implant. We quantitatively assessed the motility of the prosthesis with Kestenbaum glasses and the QoL with a validated questionnaire covering five domains: General functional abilities and care, wearing comfort, physical appearance, psychological and social functioning. Associations between measured prosthetic eye motility, patient-perceived motility, and satisfaction were made.

Results: Motility of the prosthesis was impaired with an average loss of 76%, and correlated with Cosmetic satisfaction (adduction  = .02, abduction  = .008, elevation  = .04) and Social satisfaction (adduction  = .03, abduction  = .003). The patient-perceived motility of the prosthesis correlated with General functioning abilities (horizontal  = .0004, vertical  = .0004), Comfort (horizontal  = .001, vertical  = .003), Cosmetic satisfaction (horizontal  = .0002, vertical  = .0002), Psychological satisfaction (horizontal  = .001, vertical  = .001), and Social satisfaction (horizontal  = .002, vertical  = .003).

Conclusions: Ocular prosthetic motility has a significant impact on patient-perceived satisfaction and physical appearance, and predicts coping with the prosthetic condition on the psychosocial level. This highlights the need of introducing patient-reported outcome measures in the prosthetic rehabilitation of the anophthalmic patient.