Ophthalmic Plastic and Reconstructive Surgery or “Oculoplastic Surgery” is a subspecialty of ophthalmology that focuses on diseases of the eyelids, tear canal system and eye socket (orbit).
Common problems dealt with include: diagnosis and treatment of various lumps and bumps, tearing problems, misdirected eyelashes, drooping eyelids, baggy eyelid skin, entropion (in-turned eyelid), ectropion (out-turned eyelids), infections within the eyelids, tear canal/orbit as well as a variety of traumatic injuries such as eyelid lacerations, bony fractures of the eye socket (floor fractures) and globe ruptures.
Established in 1987, and currently staffed by Dr. David R. Jordan and Dr. Steven M. Gilberg, this service is one of the busiest in the country. Over 1,800 surgical procedures are performed each year on patients who travel to the Eye Institute for their care from within the Ottawa Valley as well as other parts of the province and adjacent provinces (Quebec, New Brunswick, Nova Scotia, Newfoundland and Labrador).
Surgeons at the Eye Institute were among the first in Canada to utilize artificial eyes made with sea coral (hydroxyapatite) in 1990. Following the removal of an eye, a coralline sphere is implanted into the eye socket and becomes integrated with surrounding tissues. It will then accept a prosthesis (“artificial eye”), which has been carefully painted to match the colour of the patient’s real eye.
Over the course of several months, the implant becomes fully bio-integrated. Then, a second procedure may be performed to directly couple the prosthesis with the orbital implant (using a peg system), thereby imparting much more natural movement to the artificial eye.
Research in oculoplastics over the past 16 years has focused on perfecting porous orbital implants such as “hydroxyapatite” as well as developing new surgical procedures that provide patients with better results and shorter convalescence periods.
The oculoplastic team at the Eye Institute has implanted over 500 porous orbital implants over the past 16 years. They have investigated and help develop several alternative porous orbital implants including a synthetic hydroxyapatite implant that currently is marketed around the world.
A newer porous orbital implant (“aluminium oxide”) like synthetic hydroxyapatite also had its roots at the Eye Institute with all of the preliminary animal studies and early clinical studies completed here. Aluminum Oxide has been used in the dental field and orthopedic area for decades. It is lightweight, structurally strong and extremely well tolerated in the human body. The “aluminium oxide orbital implant” is now the orbital implant of choice by the physicians at the Eye Institute for those individuals requiring eye removal.
Future research plans include continuing on with our investigations into the refinement of orbital implants with the ultimate goal of helping those with an artificial eye regain a natural life like appearance. We will also continue on in the search for newer innovative techniques, simpler techniques as well as fine tuning of our current surgical techniques for those patients with disease of the eyelids, tear canal or eye socket.
A one year Fellowship in Ophthalmic Plastic and Reconstructive Surgery is usually offered on an annual basis, and the fellow is expected to participate in basic science and clinical research.
Surgical procedures are performed in three operating settings: The Ottawa Hospital, General Campus operating room for inpatient surgery; an out-patient operating room at the Eye Institute for local anaesthesia; and a minor procedure room, also located at the Eye Institute, where many of the eyelid procedures and biopsies are performed.