BALTIMORE - Scientists and engineers are 3D printing all types of objects, including eyes: A group of ophthalmologists and eye care providers from the Netherlands has used 3D printing technology to create artificial eye structures called constructors, the team said, in a small study of five children.
The technology could help children with conditions known as microphthalmia and anophthalmia, in which they are born with underdeveloped or missing eyes. The condition, which can occur in one or both eyes, affects more than 10 percent of blind children worldwide, up to 30/100,000 children, according to previous research.
Although sculpted eyes do not allow a child to see, they do provide the critical support of the eye sockets that allow a child's face to be natural, researchers said today (May 11) at the annual meeting of the Association for Research in Vision and Ophthalmology (ARVO), the world's largest gathering of ophthalmology and vision researchers, on a sliding scale.
"Without the eyes, there wouldn't be enough *** to make the bones [around the eye sockets] grow, said Maayke Kuijten, a postdoctoral fellow at the VU University Medical Center in Amsterdam, at ARVO, who conducted the study on five eligible children.Kuijten said that [the 10 strangest things created by 3D printing]
, because children with these disorders may have deformities of the eye sockets, the face and the area around the eyes do not extend to their natural contours. The advantage of 3D-printed eye masks, she said, is that parents can replace them at home with a slightly larger size as the child grows, or they can be replaced weekly when the child is a few months old.Kuijten told Live Science:
"Symmetry of the face is our ultimate goal. " (This is often called a "glass eye" because it was originally made of glass, but is now mostly made of medical-grade plastic acrylic.) These artificial eyes are made by ophthalmologists who are specially trained in the manufacture and fitting of artificial eyes.
Artificial eyes can be nearly spherical, like an eyeball, or cup-shaped to fit existing, deformed, and nonfunctioning eyes, Kuijten said, adding that inkwells are often used for temporary support, such as maintaining the eye socket for a few months after the unexpected loss of an eye until a more permanent prosthetic seat can be fitted.
, but fabricating and fitting a prosthetic eye seat, even a Mercator, is a grueling process. An ophthalmologist typically must visually inspect the size of the eye socket, create a sphere based on an educated guess, and polish it until it fits perfectly. It's as much a work of art as it is medical care.
For babies with microphthalmia or anophthalmia, time is of the essence, because their rapidly growing heads need a full-size eyeball *** for the frame of the eye socket to expand accordingly, Kuijten said, and without such a ***, that portion of the skull would be sunken inward.
3D-printed conformers help solve this dilemma because they can be printed quickly, cheaply, and in a wide range of sizes with diameters of less than 1 millimeter.
To test the utility of 3D-printed conformers, Kuijten's team observed a patient treated by Dyonne Hartong, MD, an oculoplastic surgeon at VU University Medical Center. Dr. Hartong, who is currently treating about 50 patients with microphthalmia or anophthalmia. Hartong is a senior investigator on the study.
Part of standard care in the Netherlands for children with these eye conditions, they have several ultrasounds of the head at 3 months of age, followed by a magnetic **** vibration scan at 3 months of age. (Magnetic **** vibration imaging requires anesthesia because infants cannot be instructed not to move during the scan. But administering a ring anesthesia is considered too dangerous for newborns under 3 months of age.)
Using these scans, the researchers determined the extent of the eye deformity and the size of the eye socket. Doctors also injected a soft gel into the affected eye sockets to create a rough model of their shape.
Based on these measurements and data on natural growth and development, Quidan created a map of the children's eye development over the next 10 years. Her team then used a 3D printer to create customized constructors in a huge array of sizes that matched the growth chart predictions. [7 Cool Uses for 3D Printing in Medicine]
Inked people don't look like eyes. In fact, the original batch of eyes were green with no pupil coloring. But after receiving orbital training from an ophthalmologist, they were convenient enough for parents.Kuijten said the treatment is noninvasive and not painful for the child.
Early evaluations showed that the volume of the sockets in the treated eyes doubled on average over the course of about a year of treatment, suggesting that significant socket expansion occurred, the researchers said. A study of these children is ongoing.
"This is certainly a novel approach with several advantages," said Dr. Irene Gottlob, the Ulverscroft Professor of Ophthalmology at the University of Leicester at Leicester Royal Infirmary and who was not involved in the study, adding that it's a good example of individualized treatment, or "precision medicine." It's also a good example of how 3-D printing technology can be used in medicine.
However, only five patients have been treated so far, and we need to look at the results of a larger group," Gottlob added.
Gottlob said she was encouraged by the researchers' plans to improve the mathematical model to better predict the growth and development of the eye sockets. She also noted that better improvements in ultrasound scanning could help bring the method to infants before they reach an age where they can safely undergo MRI*** vibration scans.
"I think this is a very promising ...... method, but experience with more patients and further development will improve this further, Gottlob told Live Science,
Follow Christopher Wanjek @Wanjek for daily tweets on health and science with humor.Wanjek is the author of Food at Work and Bad Medicine. His column, Bad Medicine, appears regularly in Life Science