Deposit buildup on prosthetic eyes and implications for conjunctival inflammation and mucoid discharge

BACKGROUND The aim of this study was to investigate deposit buildup on prosthetic eyes and the implications for conjunctival inflammation and discharge. METHODS Forty-three prosthetic eye wearers participated in the study. Twenty-three had their prostheses polished normally before being worn continuously for 2 weeks. After this time, surface deposits were stained, photographed, and graded. The prostheses were then repolished to optical quality contact lens standard and worn for a further 2 weeks, when the deposits were again stained, photographed, and graded. Two participants had deposits on their prostheses stained, photographed, and graded on nine occasions at decreasing intervals ranging from 1 year to 1 day. Eighteen participants had the wetting angles on their prostheses measured with a goniometer before and after cleaning, after polishing normally, after polishing to optical quality contact lens standard, and after 10 minutes of wearing their optical quality contact lens polished prostheses. Concordance correlation, multiple regression, and paired t-tests were used for the statistical analysis. RESULTS More surface deposits accumulated on prostheses polished normally than on those polished to an optical quality contact lens standard after 2 weeks of wear. The interpalpebral zone of most prostheses (observed without magnification) appeared to be clear of deposits. Removal of deposits significantly decreased surface wettability, but wettability returned after 10 minutes of wear. Optical quality contact lens polishing produced more wettable surfaces and a slower rate of deposit accumulation than normal polishing. CONCLUSION We recommend that an optical quality contact lens standard be the minimum standard of finish for prosthetic eyes. This standard may assist the smooth action of the lids over the interpalpebral zone of the prosthesis and the cleansing action of tears. The presence of deposits in the retropalpebral zone may improve the lubricating properties of socket fluids which, in turn, may result in less frictional irritation of the conjunctiva and less mucoid discharge.