Prosthetic Rehabilitation of Orbital Defect with Customized Silicone Prostheses Employing Novel Retention Techniques: A Three-case Clinical Report

Abstract Orbital exenteration results in severe facial disfigurement and emotional distress, making prosthetic rehabilitation essential to restore esthetics, symmetry, and psychological well-being. This case series describes the prosthetic management of three patients with orbital defects using customized room temperature vulcanizing silicone prostheses and individualized retention approaches. The cases included a postretinoblastoma defect, a post-COVID mucormycosis defect, and trauma-associated orbital loss. Each patient received a uniquely designed retention system based on anatomical undercuts and functional needs: an acrylic shim engaging the malar undercut combined with adhesive for Case 1, a two-piece prosthesis retained using neodymium magnets in Case 2, and a spectacle-assisted retention mechanism with additional adhesive support for Case 3. The report highlights that individualized retention strategies, precise artistic fabrication, and a multidisciplinary treatment approach contribute significantly to successful orbital defect rehabilitation.