Custom Ocular Prosthesis in Children: How Often is a Change Required?

PURPOSE: To evaluate the indications, outcome and replacement schedule of custom ocular prostheses (COP) in children. METHODS: Retrospective review evaluating indications, outcome and replacement schedule of COP in children (≤16 years). RESULTS: Three hundred and thirty (330) children were fitted with COP. With average follow-up of 18.05 months (range 1-50 months), 136(41.2%) children needed replacement/modification of the prosthesis. Information regarding indications for replacement/modification of prosthesis was available in 125 cases. Indications included enophthalmic prosthesis in 34(27.2%), prosthesis rotation within the socket in 25(20%), loose fit in 16(12.8%), decentration of the cornea in 15(12%), color touch up in 13(10.4%), lost prosthesis in 8(6.4%), cosmetically significant ptosis in 2(1.6%), replacement following implant exchange surgery in 2(1.6%) and combination of above factors in 10(8%). Time for replacement/modification of prosthesis was assessed in 3 age groups. In ≤3 years, 47% (36 out of 76) children underwent replacement/modification at a mean duration of 18 months (range 3-39 months) from the date of prosthesis fitting. In the 3-12 years age group, 43% (80 out of 184) underwent replacement/modification at 21 months (range 2-48 months); and in the 12-16 year age group, 29% (20 out of 70) underwent replacement/modification of prosthesis at a mean duration of 26 months (range 3-50 months). CONCLUSION: A change of prosthesis is required between 18-26 months following prosthesis placement in children. Over an average of 18 months, a change in the prosthesis was required in 41%, with the youngest age group having the highest exchange rate (47%), and the oldest group the lowest (29%).