Pioneering 3D printing for patients with eye loss
Professor Mandeep Sagoo | GR001135 & GR001179
The loss of an eye can affect confidence, mental health and quality of life as well as vision. Professor Mandeep Sagoo and colleagues are conducting a clinical trial, supported by the charity, which looks at 3D printing ocular prosthetics based on individual patient data gathered via non-invasive methods.
We’re delighted to invest in Mandeep Sagoo’s work and for the first ever patient in the world to be supplied with a fully digital 3D printed prosthetic eye. The clinical trial is the next important step in this ground-breaking programme.
Current methods to prepare ocular prosthetics are carried out by highly skilled ocularists but the technology hasn’t significantly advanced in over 50 years.
In the UK 60-70,000 people and over 8 million people worldwide wear a prosthetic eye. Rehabilitation of the socket after eye removal surgery or in congenital cases of developmental abnormalities or after severe trauma is of prime importance in the physical and psychological health of the patient.
Faced with disfiguring surgery as well as a difficult diagnosis, the art of the ocularist is as important as the skill of the surgeon.
What is an ocularist?
An ocularist is a skilled technician who will normally work within an oculoplastic team. They prepare, provide, fit and maintain ocular prosthesis. Improving the aesthetics of eye and face improves the patient’s self-confidence, self-esteem, and health-related quality of life. Therefore, their contribution as team-member of the department is significant.
Ocularists work with patients with congenital anomalies of the eye, and surround areas, and individuals who have undergone removal of the eye due to trauma, tumour, or painful blinding disease.
Despite technological advancements elsewhere in healthcare, the current process to supply ocular prosthetics to patients has remained largely unchanged for over 50 years. Ocular prosthetics are currently made individually by hand by utilising techniques from the 1950s.
Ocularists create a mould of the patient’s eye by injecting dental alginate into the patient’s socket. Over a period of weeks, the ocularist will then craft an ocular prosthetic by hand and intricately hand paint an iris to replicate the patient’s remaining eye.
Long wait times and variable results have prompted a patient-centred, clinician-led approach to harness new technology to engineer a better approach to deliver a quick, non-invasive solution.
Finding a solution
To tackle this question, a multi-disciplinary international team has been assembled. This has been critical to ensure the project can proceed towards achieving its ambitious aims to manufacture 3D printed ocular prosthetics designed on individual patient data, using non-invasive imaging, bespoke software and specially calibrated 3D printers.
• Professor Mandeep Sagoo is the clinical lead at Moorfields Eye Hospital, where the clinical trial will be conducted and Professor of Ophthalmology and Ocular Oncology at UCL.
• Ocupeye, a company formed with the sole purpose of modernising the manufacturing process of ocular prosthetics.
• Fraunhofer IGD is a leading international research institution for applied visual computing. Fraunhofer have specific expertise in the development of translational models, which is critical to the realisation of a complete digital workflow. Furthermore, Fraunhofer IGD’s expertise in the calibration of 3D printers is critical to the delivery of 3D prints with highly accurate colour and translucency reproduction.
• FIT AG are Germany’s largest 3D printing service provider. The core business activity of FIT lies within additive manufacturing (rapid prototyping, additive production). The expertise in additive manufacturing, alongside a capability to scale up production capacity as demand increases are critical functions to the development of an end-to-end workflow to manufacture ocular prosthetics.
Professor Sagoo first completed a NIHR funded i4i baseline study of motility of the current ocular prosthetic, in a long term collaboration on this project between the NIHR Biomedical Research Centre for Ophthalmology at Moorfields and UCL Institute of Ophthalmology, with Ocupeye Ltd, a UK based technology company dedicated to 3D printing of prosthetics. Now with the imaging data capture, software development and 3D printing testing underway, Moorfields Eye Charity is funding the next stage – a phase I/II human clinical trial.
This trial will look at the pathway for the manufacture of 3D printed ocular prosthetics and that the end product functions in a manner that is at least comparable to current prosthetics.
This project is designed around direct benefits to patients living with eye loss. Moorfields ocular prosthetics department treats over 2000 patients per year. Currently, patients face waiting up to 24-weeks to receive an ocular prosthetic but with a digital process, this could half the manufacturing time.
The development of a digital end-to-end process for the manufacture of ocular prosthetics will provide patients who have suffered eye loss with quality prosthetics faster than currently available. The invention could help the delivery of an superior service and product to patients.
There will be potential savings to the NHS from increased efficiencies to the current process and ocularists will have more time to spend with patients.
This project has been supported by Moorfields Eye Charity through the generous philanthropy of the Drayson Foundation and enabled by the National Institute for Health Research (NIHR) Moorfields Biomedical Research Centre.
Professor Mandeep Sagoo
Ocular prosthetics, ocular cancer, adnexal