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Thu Nov 24, 2005 2:42 pm

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Joined: Tue Jan 14, 2003 3:28 pm
Posts: 1033
Age: 53
Location: Southern California USA

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Can a CORAL-IMPLANT be replaced?

Drexler

Subject: Can a CORAL-IMPLANT be replaced?

Dear Friends. I've had a coral implant 2 1/2 years now. From the start I felt the implant was the wrong size (18 mm). To me it didn't provide enough volume. My false eye appears as thou it's sunken into the socket. My upper eyelid also withdrew back into the space between my eyebrow and my prosthesis. As a remedy the eyelid muscle was weakened thru surgery and what was called a sled was implanted under and behind the coral implant also thru surgery. All this and my eye's appearance is such that it still appears sunken; so much so that in photos I appear as if I have a black-eye. To me the remedy would be a bigger implant (20 or 22 mm's). I know tissues have grown into my coral implant in the 2 1/2 years so I wonder how difficult it would be to remove the sled and implant and go bigger with another implant. You may wonder why I don't ask my Doc this but my surgeries were done in a charity hospital by Drs. doing there residencies and if I'm going to go thru this I want a much more experienced Doc to do it. Any Dr. referrals would be a big help if in fact this is feasible.

Thanks in advance, Dre

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anna

Hi Drexler, I think it could be replaced. I am having a surgery in a week when the doctors will put for the first time the coral or MedPor implant. At the moment I've got an implant but it is much smaller. But I have to say that the doctors will find out during the operation whether it is possible, so fingers crossed. Take care. Anna

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kelycasy

Hi Drexler, this is my first post on this board and the reason I'm responding to yours is that I had a very similar problem after my coral implant. It was sunken into the socket, my eyelid was kind of drooping and I felt awful about how I looked. Since I live in Cherry Hill, NJ, just across the river from Philadelphia, I was treated at Wills Eye Hospital. I was referred to a terrific plastic surgeon at Wills, Dr. Mary Stefanyszyn. I love this lady for what she did for me. She put in a floor implant, which was made from the same coral material as the implant. That brought the implant forward enough to correct the sunken look. She also fixed both of my eyelids so that they matched. The results were incredible. No one knows I have a prosthesis unless I tell them. Perhaps what you need is a good plastic surgeon to correct what you have, rather than a new, or larger, implant. I hope I've given you some information to go on, but please feel free to ask me any other questions. And good luck to you. Nancy

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New to this board

Marsey

Subject: New to this board

Hello everyone! I have been reading posts on this board for some time and thought I'd finally say hi to everyone! I am scheduled to have a "modified enucleation" on Feb 16th. By modified I mean that my doctor is going to only leave the part of the eye that has the muscles attached, but the rest will be implant. He says that this will give me better movement. Needless to say, I'm very nervous.

The short version of my story is that I had a piece of roofing tile thrown into my left eye when I was six years old (I'm 31 now), cutting the cornea out. They saved it, but it is pretty scarred and, since I developed traumatic glaucoma in it shortly after, it's been painful and swollen for most of my life. I'm excited at the prospect of no longer having the pain, irritation, and constant questions from strangers, but I am also very scared. I'm used to how I look.

I am interested in getting the peg eventually, but my dr. and ocularist are both very much against it. They both tell me that risk of infection is high and that sometimes the peg causes movement to be "too good," which I guess means that the sides of the prosthetic can pop out when moving the eye side to side. I'm wondering if anyone else has been told this or has been discouraged by their doctor regarding the peg.

Thanks for any advice/support!!!!

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Rich

Marsey,

Welcome to the board. There are many fantastic and compassionate people here. Everyone understands.

I too was told, by my surgeon, not to get a peg for similar reasons. My prosthesis, without a peg, moves very well. It can't move to the extremes but I am satisfied. I recently hired a new employee and after 2 interviews, I had to tell him that I lost an eye to cancer. He never noticed. Therefore I'd say it looks natural.

All will go well with your procedure.

Take care & God bless. Rich

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ski

Subject: Hi There!

I too had asked my surgeon and my ocularist about the post and they were not keen on it. My surgeon states that sometimes scar tissue can grow around it and therefore I would require further surgeries as it would become uncomfortable and not fit properly. I work in the public sector and most people do not even notice my "Fake eye". Although sometimes I get funny looks if I am looking down at a document and look up from there, my eye moves great from side to side but up and down is another story all together. I have to admit that I still don't feel real comfortable with how I look. I can count the times I have put on make up in the last 5 years. I never wore much as I always felt I only needed a little to enhance them and my ex-husband always told me I had the most beautiful eyes! After all the insurance money was gone and I paid off his student loans he found he was having much more fun with his blonde haired 2-eyed, blue eyed assistant!! Am I bitter? you bet, but life goes on and I am coping!! I have met someone nice and things may progress! Sorry to go on here, sometimes I just need to vent!

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Rich

Ski,

Never feel sorry for venting. There are those who don't understand those who have lost an eye. Can't say much for a person who takes the money and runs.

Rich

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Chris

Marsey,

Welcome to the board. I hope that you find the advice and camaraderie here to be as extraordinary as I do!

Ski,

Funny, right before my accident, the "coolest" girl in my school (whom I was trying to be friends with) gave me the biggest compliment. She said, "You have the most beautiful eyes. They're your best feature", then, BOOM, it happened. .

Sorry about your situation with your ex. Although I DOUBT his being so lame had anything to do with your eye, right? Sorry you had to experience that!!

As far as makeup, I stayed away from it, figuring it would only make my eyes look more different. It took an understanding, experienced ocularist to show me how to try using eye makeup, and to this day I'm never without it!!

One more thing--at least your prosthesis has SOME movement. Mine does not move an inch--not left, not right, certainly not up nor down. I've learned to TRY to be conscious of it and accommodating myself by moving my head more, but then once in a while I'll see pictures of myself with my eyes looking in two different directions, or the up/down thing you said, and it makes me want to crawl away and hide. Guess it's hard to accept sometimes. .

~Chris~

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Starter

I don't have the peg, and my eye barely moves any at all, would the peg help me????? Mine doesn't seem to move as good as other peoples for some reason. I try to strengthen my muscles by moving my eyes around a lot when I'm by myself, but I haven't really noticed any difference. Is there anyone else in here, who hardly had any movement to begin with, and the peg made a difference in there eye movement? I guess the question is, my implant does move some, and the peg would have to increase the movement, at least a little right? Someone please help.

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I need opinions.

Starter

Subject: I need opinions.

Ok, I just visited the doctor who installed the coral implant back in July. He had me look in all directions, and he said your eye movement is as good as planned. Then he had me remove my prosthesis and he said the implant moves pretty good, considering the damage done by my accident. He said the movement wasn't being transferred well from the implant to the prosthesis. He also stated the reason was my bones were broken so badly that the implant wasn't far enough forward and therefore they had to make the prosthesis really thick thus, less movement. He told me that I could have the implant moved forward and my prosthesis thinned down and ad a peg to the prosthesis, and I would get about 30 or 40 percent better movement. Should I undergo this surgery? would any of you? He said the peg would not help me in the current situation. I wish both my eyes did this

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Chris

Starter,

Interesting questions. Would I undergo that surgery with the hopes of my eye movement improving 30-40%? Heck, yeah! I have ZERO movement now, and if the surgery wouldn't be too bad, I'd certainly sign up to do it! It all depends on how long the surgery would be; what the surgery would entail; how long recovery would be; what exactly would be involved, etc. If you're talking about a pretty quick recovery and then just getting the prosthesis re-done, yup, I'd do it!

You know what? Take your time and think about it. Think it over. Do you want to take that recovery period and go through all of that?? It's totally up to you. If he's not rushing you into surgery, I'd think it over for a while! Good luck with your decision and let us know how it goes!!

~Chris~

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kelycasy

Starter,

I am a big supporter of the peg because mine works so wonderfully. I sometimes hesitate to respond to posts like yours, because I am so pro-peg. I realize, though, that everyone has their own ideas, and I respect that. I'll borrow a phrase from Dr. Phil - "Never substitute my opinion for your own."

That being said, it sounds like your problem is very similar to mine when I first got my implant. It looked sunken into the socket, and I was very self conscious of it. The first attempt to fix it was to build up the prosthesis, like you had done, with the same result you have. I then went to a plastic surgeon who specializes in eyes and she recommended a floor implant for the socket. The implant is of the same coral material and is kind of packed on the floor of the socket and pushes the ball implant forward. It worked perfectly. I don't know what your doctor is suggesting for you, but this is what worked for me.

I then had the peg put in. I had to wait for the swelling to go down so that the peg could be correctly placed. I would also recommend the sleeved peg, because the first one I got wasn't and in time, it started to push out. Since having the sleeved peg, I have had absolutely no problems with it. And I've had it for 10 years. And the movement of my prosthesis is very natural looking. I don't think I could do anything more to improve how it looks and moves.

Good luck to you, Nancy

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Guest

Subject: thanks

Thank you guys for your opinions, I have been thinking about this all night, and I will continue to put more thought into it. But as of now, my mind is pretty set on doing it this summer, after I return from the beach. The only bad part really is, I know it will cost a fortune! But I think it would be worth it, I could ditch these dark glasses and actually appear to have a functional eye. Well, time to go exercise and relieve some stress. .

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Starter

Subject: This is starter.

It's me starter, how come it listed my last reply under guest??????????????????????????? that is odd.

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Jay

I don't have much movement, but it doesn't bother me. I've got a belly that moves a lot that makes up for it.

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roadrunner

Starter, I just went to the eye guy this week, the same thing, wanting the post. He told me the same thing as you. He said my prosthetic was too far back, and the peg wouldn't work well. He suggested building up from the back, I think he called it a sled. But in all honesty, he didn't sound really like he was recommending this, just that these surgeries were available to me. My eye does have fair amount of movement. I left the office feeling a little down, but have decided not to have the surgery at this time. He said that in years to come, the eye could sink further back, then it might be more worth my while to get the sled thing.

Good luck.

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guest

just to throw it out another opinion. I don't have much movement and was told its because my implant is in the wrong place and was offered the same surgery to fix it. it would be one surgery to remove my current implant and one more surgery, 6 weeks later, to put in a new implant. 3 months of my life and the risks of surgery are not worth trying to get my eye to look better. so no, I wouldn't do it. take off the dark glasses.

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Starter

Subject: however.

This is a valid point you have made guest, and I appreciate your advice, however, my surgery will not be as complex, they do not need to remove the current implant, they just need to put something behind it to move it forward, and then put in the peg. I have tried going into Wal-Mart at night without my glasses, I find myself hanging my head down most of the time. I am trying to break myself from it. The good thing about the glasses is that no one asks about my eye.

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To lelycasy.

Starter

Subject: To lelycasy.

Hey kelycasy, how was the movement before you got the peg, and how is it now?

The thing is, the up and down movement of my implant, isn't that good, and when I try to see the implant moving in the mirror, it doesn't seem to move that much, but it seems to move good when I place my finger on it.

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kelycasy

Hi Jarrod,

As I remember (I lost my eye 12 yrs ago and got the peg about 6 months afterward, so I didn't have a lot of time without it) the movement of my eye without the peg was so-so. It wasn't enough to satisfy me, but I was told by my ocularist and doctors that it was typical.

After the peg, I'd have to say that the movement got back to about 75% of normal. In fact, whenever I go for a checkup to either the doctor or ocularist, they comment about how good it moves.

When are you getting your peg??

Nancy

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Australian Experience with peg

anna

Subject: Australian Experience with peg

Hello there, I was wondering if there is anyone from Australia here who has a coral implant with a peg? I am planning to have one (peg) and would love to talk to someone how it looks, works etc. Please feel free to e-mail me on: australiafoto <at> yahoo.com Thanks guys. Anna

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Chris

Anna,

I'm not from Australia, nor do I have the peg, but I want to wish you luck when/if you get it! Sounds so promising to those who do take the plunge and get it!!

~Chris~

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guest

I am wondering about the peg too, My movement is pretty good except when I look to the sides. .everyone told me that the peg would improve that, but my Dr. said it is not worth the trouble. .He said people with the peg have problems with infections. the ocularist ( spelled wrong ) said the same thing. I would love better movement, but am afraid to try it since I cant go back. .I wonder how bad the operation is. I wish I knew someone with it and would tell me all about it, the good and the bad. need to hear both sides of the story. .

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kelycasy

Dear Guest,

I have had the peg for many years and can't imagine not having it! The movement of my prosthesis is almost "natural." I have recounted my experience with the peg in several postings here. You may want to click on my profile and then click on read all of my posts for my story. I would be happy to answer any questions you have, either here on the board, or you can pm me.

Look forward to hearing from you, Nancy

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guest

Hi guys, Getting the peg is only an option if you have an HA(Coral) or MedPore implant. And, yes, there is a much higher risk of infection/exposure associated with these types of implants, not to mention they are much more expensive (as opposed to an acrylic sphere) If they do have that type of implant, many patients opt not to get drilled for the peg simply because their movement is fine with out it. Other factors include cost (titanium pegs can cost $150.00 or so and those little buggers are easy to lose! LOL). Some people have a problem with the "clicking" sound that may happen with the peg, and don't forget that not all eyes are created equal. Some shapes simply can't allow a peg hole due to size. These are just other factors that you, your doctor, and ocularist must consider. It simply is not a solution for every prosthetic wearer. Period. Get informed for YOUR particular situation. good luck

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kelycasy

Very well said. I agree the peg isn't for everyone as circumstances vary.

Titanium pegs weren't around when I got my peg in 1992. It's plastic, and has a sleeve. The first one I got did not have a sleeve, and after about six months, it began to be pushed forward. Then I got the sleeved peg and have had not problems since.

It also requires a good ocular plastic surgeon, which I had, to place the peg correctly. It's a little tricky getting it right.

I'm sure the debate about pegs will go on forever. I'm glad this forum is available to those having questions about it. Thanks for your input, as you raised some very important issues.

Nancy

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ongoing complications with implants

lacey michelle

Subject: ongoing complications with implants

Hello. I'm new here. I lost my eye due to a faulty juicer (of all things) while working at a corporate health food store here in Memphis. This incident occurred 4 1/2 years ago. I had a craniotomy to ensure that my brain was fine and to insert a titanium plate into my skull to help rebuild it. My eye was enucleated shortly thereafter.

I originally had a hydroxyapatite (spelling?) implant. I eventually had it pegged. An exposure occurred and I had a graft (from the roof of my mouth) to try and correct it. This didn't work and the implant became infected. ETC. Needless to say, I've had numerous surgeries (just had my 11th) including a dermal fat graph, an acrylic orb insertion, and now another hydroxy orb insertion. This last surgery was done on August 17th. Yesterday I noticed ANOTHER exposure and today it seems to have grown already.

I'm going to try and get in touch with my doctor first thing this morning, but. I'm scared to death. I don't want another surgery!!! Does anyone have experiences like these? What kind of suggestions might anyone have? I took the conformer out because it seemed to be rubbing on the exposed parts, making them worse.

Any advice/encouragement/personal stories would be greatly appreciated!!!

Thank you.

-Lacey

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sherri

Subject: I wish I could help more. .

Dear Lacey: I still have my eye, but no vision due to choroidal melanoma, which was found in a routine eye exam. I'm looking at enucleation due to the rapid deterioration of my eye from radiation treatment. I am sorry for what happened to you. It seems like it was a fluke accident??? The surgeries don't seem to be working? Have you sought a second or a third opinion? It is your right to seek enough opinions to make you feel comfortable. Although, insurance doesn't always cover it. Mine has, but they will pay for the eye removal, but only 50% for a prosthesis (sp). This website is so supportive and actually I'm kind of a lurker here. I'm sure you'll hear from many more that will give you great advice. I just wanted to post and to give you support. I am so sorry you need to be here, but this is a great group to get information, support and to meet people with the same circumstances that you have. Don't ever feel alone. This group is here for you.

All my best to you and wish I could say and do more for you, Hugs:)Sherri

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Chris

Lacey,

First of all, welcome. You'll find great information and support here.

Sorry about your accident.

I wanted to let you know that I had multiple surgeries (about 30) and have had problems with rejection of all implants. I found a doctor in Manhattan (Dr. Albert Hornblass) who put in silicone beads instead of the one silicone ball implant (which I had rejected). The beads have stayed in there for 25 years or so and haven't moved.

I'd ask your doctor what other implants they're thinking of, since you seem to be so sensitive (like I was). Good luck, and if you need any further information, we'll try to provide it. Take care.

~Chris~

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Alan'sDaddy

Alan is going to have his eye enucleated within the next three months, and obviously will have an implant after that. Being ignorant on this topic, I guess I always made the assumption that implants and the "after-market" eyes were pretty much maintenance free, aside from occasional cleaning and check ups.

From some of the things I have read here though, I am starting to get worried that he is going to have life long problems. Are the problems I am reading about the exception, or is a dry/itchy/weeping eye, or constant pain/irritation going to be a part of life for him?

Remember. .It could be worse.

John

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pearl

Lacey, sorry to hear about all your complications - I'm sure everything will work out in the end. Hope your doctors appt went well.

As far as my story goes, I had my eye removed at six (retinoblastoma) and I've worn a prosthesis ever since. To answer Alan's Daddy's question. I never had any problems until the past few months - my eye teared regularly and everything. Matter of fact I rarely thought about it. In May I had a second implant surgery which altered my socket and lids and evidently my tear ducts. I feel like I just now lost my eye b/c everything is so different. I would just recommend being in contact with your ocularist throughout the entire process. In my case it probably would have changed my decision to have the surgery

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recessed eye - hollow look

mak

Subject: recessed eye - hollow look

I had choroidal melanoma two years ago and had my eye removed. My eye looks a little set back compared to my real eye. Also the fat or skin on the eyelid that I have on my real eye, disappeared over my prosthetic after the enucleation. It looks kind of hollow on the eyelid below my brow. I just want both my eyelids to look the same.

My last dr. kept telling me he wanted to wait for a gel implant to be approved by the FDA to put in the eyelid to fill it out. We've moved, and my new dr. says I need an implant under the actual coral implant to bring the eye forward and that will fill in my eyelid. But, she won't do it until I'm 5 years out from the enucleation! She said something about not wanting to disturb the socket.

Sorry this is so long. Has anyone else had this problem and has your dr. fixed it before the 5 year mark? Thanks so much!

mak

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Guest

Hi Mak I too have the same problem you have it is 2 years since my eye was removed due to a malignant melanoma, I also had to have radiotherapy treatment to make sure none of the cancer had spread into my socket. This killed off any bad cells but also badly damaged the muscles in my socket so I have a very sunken in look which I hate. I saw my doctor about 2 months ago and he has put me on the waiting list for plastic surgery to try and improve things. I live in the UK so I don't have to pay but also don't know how long I will have to wait. I have never been told about waiting 5 years for surgery and I have had 2 ops on my socket already but I am sure someone else will answer your question. Where do you live Mac and how old are you Hope to speak again Anne

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kelycasy

Hi Mak,

I had exactly the same problem after my enucleation for choroidal melanoma 12 years ago. Fortunately, I had an excellent ophthalmic plastic surgeon that fixed it for me.

Five months after my enucleation, the plastic surgeon gave me a floor implant, which sounds like what your new doctor suggested. The implant fixed the sunken look that I had. I then had both eyelids done, because they were uneven, too. Now, both eyes and lids look alike.

This was my experience. I don't know if your doctor feels there is some other underlying reason for waiting so long, besides disturbing the socket, but I think I would get a second opinion.

If I can answer any other questions, feel free to ask!

Best wishes, Nancy

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Michael

I know there are different sizes to the implants. It's important that the Dr. used the correct size for your socket. I know my Dr. was concerned about it. He, or one of his team had to travel to another state to pickup the correct size. My Dr. used a MedPor. This was to keep the correct size behind the prosthesis, and to keep the socket from looking shrunken. Hope this helps.

Regards, Michael

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Chris

I hope you have luck with a different implant (eventually). I've rejected my first implants and then found a doctor who tried a new approach--silicone beads. I've had it for over 30 years, and he's afraid of changing it now.

I notice that when I have a bad headache (migraine) or my sinuses are bad, then I have that sunken in look.

~Chris~

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mak

Thanks for the replies. Maybe at my next 6 month checkup I'll try another doctor. I've heard there are two really good ones here in Phoenix, I think I'll see what the other one says next time.

Anne, I'm 26 and living west of Phoenix by the Air Force base.

Is anyone else here in their 20's? My doctors keep telling me I'm one of the youngest patients they've had for CM.

mak

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question?

StarJLS

Subject: question?

Hi Everyone, I have a question and I would REALLLLLLY appreciate it if someone would respond with a suggestion or some past experience. For those of you who have had your eye enucleated in the past and then rejected the implant, what were some symptoms that you were having to signal you that something was wrong with the implanted eye? I really haven't been feeling well lately and I have been having numerous tests done but they cant seem to find the source. I have developed a pixilated vision in my left (healthy) eye and I thought maybe this was a sympathetic situation to the implanted one signaling that something was wrong with the implant. My parents suggested that I take the prosthesis out last night to see if my symptoms change because I also have been having intense headaches all week but nothing changed. Ever since I put the eye back in it just hasn't felt the same. I don't know if I am jumping to conclusions and I don't want to alarm my ocular surgeon just yet. If someone who has experienced this or a failed implant could write back I would really appreciate it and maybe it would give me some form of relief. I truly appreciate it and love you guys! Hope everyone else has a good day Love, Jodi

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Chris

Jodi,

I rejected MANY implants after my initial enucleation. I didn't feel symptoms with my healthy eye. I only felt intense pressure in my socket and then my body physically rejected the implant, right out of my socket. It was like a horror movie.

If you're feeling pressure or pain in that socket, please, call your doctor as soon as possible!! Good luck!!

~Chris~

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Could there be?

Starter

Subject: Could there be?

I know it's probably a stupid question, but I wonder if there is any doctor who can perform surgery and increase eye movement? Like surgery on the muscles? There has to be, I mean doctors work on muscles all the time!

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Willeke

Hello Starter,

I was just checking some of the older discussions and ran in to your postal.

I don't think the muscles are the problem. My (removed) eye moves perfectly all the way around. Problem is that the artificial eye has edges that "bump" into obstacles it cannot rotate under (eye socket) like a real eye does and therefore won't turn further. Up and down looks great, to the left looks great but "looking" towards my nose is a lot less perfect.

I am happy with my artificial eye though. I just turn my head more instead of just moving the eyes.

Hugs, Willeke

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Michael

I did hear something about a new prosthetic eye that uses magnets behind it. When your transplant moves, the magnets complete the movement cycle. I just can't remember where I saw it though.

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maxcat40

Hi, my muscles were attached the implant. I was told if I wanted more movement there is a new procedure out, but my doctor opted against it because it is a longer surgery process and in my case I had cancer and follow up appointments. would be hard to gauge if the cancer ever came back to the socket. It's done in San Francisco and I'm sure other medical facilities. My doctor said he did it mostly on Movie Stars. I will try to find the correct name for you. If your interested I could give you my Drs. name for a consult. Hugs, Sherri

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OneWarrior1

Subject: A solution

There is a way to get a little bit more movement and it is the peg. My doctor, however, suggested against it because it might complicate things in the eye. Also, the movement with the prosthesis is fair enough.

Mike

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Jay

To heck with the movement, I still want a laser pointer.

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anna
yep, laser pointer sounds good for me. Almost everyone can move the eyes. but laser point? This is SOMETHING!

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Artificial eye

borisa

Subject: Artificial eye

Hi: Happy to have found this site as confusion has led to questions. Nov. 1 they will remove my left eye which has gradually gone totally blind since the radioactive plaque treatment nearly 6 years ago. But a change produced pressure headaches plus constant irritation, so I made what I hope is a good decision. The doctor says I am a good candidate for a magnetic implant which will control eye movement, if I understand correctly. I can find no info on this, so I turn to you folks with the hope that someone either knows about this or can tell me where I can learn more. Thanks much.

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Marmalade

I haven't heard of anyone having one of those for a while but if you explore a website something like

http://www.ioi.com/

you will see how implants in general work. With a magnetic sort a magnet is used to keep the prosthesis 'stuck' to the implant so that the eye tracks along with it.

I couldn't find much about it except this.

http://www.porexsurgical.com/english/su ... ractor.asp

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_________________
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Check out "Lost Eye : Coping with Monocular Vision after Enucleation or Eye Loss from Cancer, Accident, or Disease" at http://www.amazon.com/gp/product/0595392644 and my e-mail is jay_adkisson [at] msn.com



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