Does the material of the external ocular prosthesis matter? Clinical outcomes after enucleation with orbital implantation.

PURPOSE: The influence of ocular prosthesis material and patient-related factors on clinical outcomes following enucleation with orbital implantation remains insufficiently characterized. This study evaluated clinical outcomes in relation to external ocular prosthesis material, age, and gender. METHODS: This cross-sectional study included 58 patients who underwent enucleation with orbital implantation. Acrylic prostheses were used in 19 patients (32,6%), while 39 (67,4%) used glass prostheses. Subjective evaluation was based on a 4-item questionnaire assessing patient-reported postoperative outcomes. Objective assessment used a 4-point scale to evaluate upper eyelid sulcus symmetry, color matching, prosthetic motility, and eyelid position and was conducted by investigators. RESULTS: Patients using glass prostheses demonstrated better objective clinical outcomes than those using acrylic prostheses in the unadjusted analysis (p = 0.038). However, this association was no longer significant after adjustment for age, gender, and time since enucleation (p = 0.058). Objective clinical outcomes were rated lower than patients' subjective assessments (p = 0.004). Older patients reported higher subjective ratings than younger individuals (p = 0.001), and their subjective assessments exceeded objective evaluations (p < 0.001). In the adjusted analysis, younger age (18-49 years) remained the only independent predictor of lower subjective assessment scores (p = 0.002). CONCLUSIONS: Both glass and acrylic ocular prostheses were rated favorably by patients. Prosthesis material was not an independent predictor of objective or subjective outcomes after adjustment for age, gender, and time since enucleation. Patients tended to rate outcomes more favorably than clinicians, particularly in older age groups.