Post Operative Severe Edema
(Rx: Pressure Stem Conformer)
 

Whenever there is prolapse of the lower eyelid and edematous eversion of the orbital tissue after an enucleation the eyelids will not support nor retain a conformer or prosthesis.  This in most instances can be considered a short term condition, but must be dealt with in such a manner that the supportive tissues and eyelids will be restored to their respective position.  It would require the ocularist to place an appropriate sized pressure stem conformer behind the eyelids to prevent further protrusion of the underlying tissues.  As the edema subsides the lower cul-de-sac will reform (depending on the severity of the trauma) and the stressed orbicularis muscle will gradually regain its strength and function.

Figure 22A Here are two examples of empirically designed pressure stem conformers, each is shaped with an emphasis to reform the culs-de-sac for specific edematous conditions of the eyelids and the surrounding tissue.  The pressure stem attachment is removable and can be used on various sizes and shaped conformers.

Figure 22B This demonstrates an inserted pressure stem conformer being held in position with finger pressure.  It will then require a strip of adhesive tape from forehead to cheek for long term retention (30 to 45 days). It would be removed daily only to cleanse the cavity, eyelids and lashes.