Background

It is of all times for people to wear jewelry. Earrings, make-up and more recently tattoos and piercings are accepted forms of body cosmetics. Surprisingly, no jewelry is available for the organ that is most important in social interactions, the eye.

Surgical technique

In 2002 the Netherlands Institute for Innovative Ocular Surgery developed a cosmetic extraocular  implant (CEI) that can be implanted within the superficial, interpalpebral conjunctiva. The implant does not interfere with the ocular functions, ie the visual performance and motility. The CEI is made of a specially designed material that can be molded in all kinds of desired shapes and sizes.

Download CEI instruction for use. The instructions for use include a detailed description of the surgical technique and can be downloaded.

Download Video on CEI implantation. The video shows all surgical steps of a CEI implantation under eye-drop anesthesia:

• The eye is anesthesized with routine eye-drop anesthesia medication.
• The eye is decontaminated and draped with routine techniques used in ocular surgery.
• An INTRAconjunctival bleb is created by injection of BSS in the most superficial conjunctival layer. The bleb may be positioned adjacent to the temporal limbus.
• With conjunctival scissors, the bleb is opened and a superficial intraconjunctival tunnel is made.
• The tunnel is checked to determine if it is wide enough to accomodate the CEI implantation device.
• The CEI is then loaded into the CEI implantation device, and the device is inserted into the tunnel up to the desired final position of the CEI.
• Using a routine fine-forceps, the CEI is removed from the CEI implantation device and the CEI implantation device is withdrawn from the conjunctival tunnel.
• With a spounge, all excess BSS is removed from the implantation area.
• At the end of the procedure, antibiotic drops are applied onto the eye.
• Postoperative management includes antibiotic eyedrops for 1-2 week(s).

Information on CEI wet-lab training is available on the NIIOS webpage on surgical training

The CEI is called 'JewelEye' and is manufactured and distributed by Hippocratech b.v., Rotterdam, The Netherlands. The 'JewelEye' available in the following shapes:

• Heart
• Star
• Eurosign
• Four-leaved clover
• Music note
• Other shapes on request

The CEI implantation device is available through Hippocratech b.v., Rotterdam, The Netherlands.

Clinical results

Patient satisfaction is high and no side effects of the treatment have been noticed with a follow-up of more than one year.

Clinics

In the Netherlands, the JewelEye can only be implanted by a registered ophthalmologist under sterile conditions The treatment is performed in the clinics below

• Cornea Clinic, Rotterdam, Laan op Zuid 390, 3071 AA Rotterdam, The Netherlands, phone +31 10 297 4444
• Oogzorgcentrum Driebergen, Traaij 42, 3971 GP Driebergen, The Netherlands, phone +31 343 522 193 or +31 343 516 718

References

• Melles GRJ, Ververs B, van der Linden JW: Cosmetic Extraocular Implant. J Cataract Refract Surg 2004;30:1595.