Cosmetic Appearance After Eye Loss: The Role of Prosthesis Motility and Eyelid Function
- 1The Ruth and Bruch Rappaport Faculty of Medicine, Technion—Israel Institute of Technology, Haifa 3525433, Israel
- 2Department of Ophthalmology, Bnai Zion Medical Center, Haifa 31048, Israel
- 3Department of Ophthalmology, Carmel Medical Center, Haifa 3436212, Israel
Abstract
Background/Objectives: We aimed to clarify which clinical and prosthetic features are most strongly associated with cosmetic appearance after eye loss. Methods: This prospective cross-sectional study included 107 patients with unilateral anophthalmia wearing acrylic prostheses. Examiner-rated cosmetic outcomes—eyelid symmetry, orbital fullness, prosthesis recognizability, and overall appearance—were graded by three independent raters. Candidate predictors associated in univariate analysis (p ≤ 0.10) were entered into blockwise multivariable regression across four domains: clinical background, socket and eyelid anatomy, prosthesis alignment and motility, and prosthesis dimensions. Results: Levator function (β = 0.19, p = 0.02) and prosthesis motility (β = 0.68, p < 0.001) predicted eyelid symmetry (R2 = 0.61). Orbital fullness was predicted by relative exophthalmometry (β = 0.27, p = 0.039) and motility (β = 0.34, p = 0.002; R2 = 0.34). Recognizability was predicted by motility (β = 0.55, p < 0.001) and history of additional periocular surgery (β = −0.22, p = 0.008; R2 = 0.46). General appearance was predicted by lagophthalmos (β = −0.38, p < 0.001) and motility (β = 0.35, p < 0.001; R2 = 0.69). Prosthesis dimensions were not independently associated with any of the outcomes. Conclusions: Cosmetic appearance after eye loss was most strongly associated with dynamic anatomical features. Prosthesis motility consistently predicted all appearance domains, while upper-eyelid function was associated with symmetry and overall impression. In contrast, background and static anatomical or prosthesis features showed limited independent associations once dynamics were accounted for. These findings highlight prosthesis motility and eyelid dynamics as important considerations in rehabilitation and routine follow-up, while cosmetic outcome assessment should incorporate dynamic features alongside conventional static measures.
Related
- Structure and Function of the Type IX Secretion System for Protein Secretion and Cellular Motility
- Intravital single-cell behavior profiling reveals disrupted germinal center B cell motility and interactions by EZH2 gain-of-function mutation
- Morphological changes in the eyelid following modified rotational suturing combined with lower eyelid margin fixation for the correction of congenital lower eyelid epiblepharon
- Multimodal imaging reveals surface degradation of voice prosthesis implants resulting from colonisation by polymicrobial biofilms
- Limb-specific mediolateral ground reaction force impulses during cross-slope walking in unilateral lower-limb prosthesis users
BibTeX
@article{vardizer2026cosmetic,
title = {{Cosmetic Appearance After Eye Loss: The Role of Prosthesis Motility and Eyelid Function}},
author = {Yoav Vardizer and Oren Tomkins-Netzer and Yinon Shapira},
journal = {Journal of Clinical Medicine},
year = {2026},
month = oct,
doi = {10.3390/jcm15208054},
url = {https://www.mdpi.com/2077-0383/15/20/8054},
note = {CC BY 4.0},
}
RIS
TY - JOUR
TI - Cosmetic Appearance After Eye Loss: The Role of Prosthesis Motility and Eyelid Function
AU - Yoav Vardizer
AU - Oren Tomkins-Netzer
AU - Yinon Shapira
PY - 2026
DA - 2026/10/01
JO - Journal of Clinical Medicine
DO - 10.3390/jcm15208054
UR - https://www.mdpi.com/2077-0383/15/20/8054
AB - Background/Objectives: We aimed to clarify which clinical and prosthetic features are most strongly associated with cosmetic appearance after eye loss. Methods: This prospective cross-sectional study included 107 patients with unilateral anophthalmia wearing acrylic prostheses. Examiner-rated cosmetic outcomes—eyelid symmetry, orbital fullness, prosthesis recognizability, and overall appearance—were graded by three independent raters. Candidate predictors associated in univariate analysis (p ≤ 0.10) were entered into blockwise multivariable regression across four domains: clinical background, socket and eyelid anatomy, prosthesis alignment and motility, and prosthesis dimensions. Results: Levator function (β = 0.19, p = 0.02) and prosthesis motility (β = 0.68, p < 0.001) predicted eyelid symmetry (R2 = 0.61). Orbital fullness was predicted by relative exophthalmometry (β = 0.27, p = 0.039) and motility (β = 0.34, p = 0.002; R2 = 0.34). Recognizability was predicted by motility (β = 0.55, p < 0.001) and history of additional periocular surgery (β = −0.22, p = 0.008; R2 = 0.46). General appearance was predicted by lagophthalmos (β = −0.38, p < 0.001) and motility (β = 0.35, p < 0.001; R2 = 0.69). Prosthesis dimensions were not independently associated with any of the outcomes. Conclusions: Cosmetic appearance after eye loss was most strongly associated with dynamic anatomical features. Prosthesis motility consistently predicted all appearance domains, while upper-eyelid function was associated with symmetry and overall impression. In contrast, background and static anatomical or prosthesis features showed limited independent associations once dynamics were accounted for. These findings highlight prosthesis motility and eyelid dynamics as important considerations in rehabilitation and routine follow-up, while cosmetic outcome assessment should incorporate dynamic features alongside conventional static measures.
SN - 2077-0383
ER -