Abstract
Purpose :
Blepharoptosis is a common and potentially debilitating clinical problem. An eyelid crutch is a non-surgical intervention used to temporarily lift the eyelid for patients that are unable to undergo surgery, or for whom the ptosis is considered temporary. Traditional eyelid crutches are made by a specialized optician and is custom made of plastic or metal that is attached to a patient’s eyewear. The manufacture and custom fitting of eyelid crutches can often present a cost barrier to patients. We hypothesize that 3D printing can be used to rapidly create custom fit eyelid crutches at a low cost.
Methods :
With the necessary measurements such as eye to frame distance and amount of ptosis, eyelid crutches consisting of an arched support and two clips were designed using the SolidWorks software for a patient with chronic progressive external ophthalmoplegia, severe ptosis and exposure keratopathy with corneal thinning. The crutches were designed to clip onto the upper frame of a patient’s usual eyeglasses and the patient was instructed on use of the crutches with aggressive lubrication of the eyes. The crutches were printed with Formlabs clear photopolymer resin using a Formlabs 2 stereolithography 3D printer.
Results :
The patient was fit with the eyelid crutches and found to have margin reflex distance-1 improved from -2 mm to 1 mm bilaterally. To improve patient comfort, the thickness of the crutches was reduced and an improved pair of crutches were made and given to the patient.
3D printing allowed low cost, rapid revision and manufacture of custom eyelid crutches that resulted in improvement in patient’s MRD-1 and subjective vision. In addition, patients with severe exposure keratopathy or at risk for the same can benefit by utilizing eyelid crutches only when needed to decrease their corneal desiccation.
Conclusions :
The use of the custom, 3D printed eyelid crutch proved to be an effective and inexpensive method to help manage ptosis. This study is an example of how 3D printing can be used as a tool to bring tailored and more affordable healthcare to patients.
This is an abstract that was submitted for the 2017 ARVO Annual Meeting, held in Baltimore, MD, May 7-11, 2017.