3D Printer Makes Mask in Hours for Eye Cancer Patients

Marcia Frellick

November 05, 2014

Facial prostheses for eye cancer patients who have undergone exenteration can be made much faster with 3D printing than with traditional methods, and at a fraction of the cost, a research team has shown.

Conventional prostheses cost from $12,000 to $25,000, whereas the printed version costs about $500, said David Tse, MD, from the Department of Ophthalmology at the University of Miami School of Medicine. This is a huge savings for patients, because insurance doesn't typically cover the cost of the prosthesis, he told Medscape Medical News.

The 3D-printed prosthesis (Photo courtesy of Dr Tse)

Dr Tse and his colleague, Landon Grace, PhD,from the Department of Mechanical and Aerospace Engineering at the University of Miami in Coral Gables, Florida, presented the process at the American Academy of Ophthalmology 2014 Annual Meeting in Chicago.

Doctors diagnose more than 2700 new cases of eye cancer every year in the United States, according to the American Cancer Society. The disease can occur at any age.

Exenteration is a life-saving surgery that removes the contents of the eye socket and other tissue, explained Dr Tse. "With this fairly mutilating procedure, you correct the patient's functional problem — cancer — but you create a psychological problem for the patient. Making a prosthesis that looks close to the normal eye is the initial step in rehabilitation," he said.

Mary Beth Aronow, MD, assistant professor of ophthalmology at the Wilmer Eye Institute at Johns Hopkins University in Baltimore, said that although some of her patients are comfortable wearing an eye patch or not covering the socket, for many, a low-cost alternative could be life-changing.

Dr Tse's patient wears the 3D-printer-produced prosthesis on her right eye (Photo courtesy of Dr Tse)

For traditional prosthetic fabrication, an ocularist makes a mold of the face, casts it in rubber, and then add tints and features such as eyelashes, all of which can take weeks.

In contrast, the 3D printer can have a mask ready in about 8 hours, and production can be done in remote settings that have no access to an ocularist.

Patients are scanned on the undamaged side of their face and software creates a mirror image. That 3D image, merged with an image of the back of the eye socket, is transmitted to a 3D printer, which creates a rubber mask suffused with pigment in nanoparticles to precisely match skin tone. After eyelashes are added, the prosthesis is ready to wear.

More precise, personalized matching would be a big advantage for patients over current prostheses, said Hakan Demirci, MD, director of ocular oncology at the University of Michigan Kellogg Eye Center in Ann Arbor, who praised the innovative approach.

Some of his patients use makeup to try to smooth the transition from the prosthesis to the skin, and maintenance can be tedious, he told Medscape Medical News.

Nanoclay protects the prosthesis from breaking down and changing color when it is exposed to light or moisture. If it needs to be replaced over time, it is as easy as pressing the printer button. Replacing a standard prosthesis means repeating the procedure at the full cost every 3 or 4 years, Dr Tse explained.

He said he was inspired years ago when he treated a young girl with an empty socket whose parents couldn't afford an ocularist. The ophthalmologist raised money himself for her first prosthesis. The patient, now a teenager, is scheduled to be scanned for a 3D printed prosthesis later this month.

Dr Tse said that his team is refining the process, smoothing out the edges so that the prosthesis blends seamlessly into the surrounding skin, and tweaking the skin pigment technology. He also said that he would eventually like the eye, which currently doesn't move, to swivel.

He has made one prosthesis so far, but he envisions global use when the technology is mass-market ready.

"Once we have a patient scanned, we have the mold, so we can create a new prosthesis in no time," Dr Grace said in a news release. "Our long-term goal is to help patients anywhere in the world. We could get a mobile scan, download the data in Miami, print out the prosthesis, and ship it back to the patient the next day."

Dr Tse, Dr Grace, and Dr Aronow have disclosed no relevant financial relationships.

American Academy of Ophthalmology (AAO) 2014 Annual Meeting. Presented October 20, 2014.

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