Sunah Kang1, Jaeyoung Kwon2,3, Chan Joo Ahn1, Bita Esmaeli4, Guk Bae Kim2,3, Namkug Kim2,3, Ho-Seok Sa5,6. 1. Department of Ophthalmology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea. 2. Department of Radiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea. 3. Department of Convergence Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea. 4. Ophthalmology Section, Department of Plastic Surgery, The University of Texas M. D. Anderson Cancer Center, Houston, TX, USA. 5. Department of Ophthalmology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea. lineblue@hanmail.net. 6. Ophthalmology Section, Department of Plastic Surgery, The University of Texas M. D. Anderson Cancer Center, Houston, TX, USA. lineblue@hanmail.net.
Abstract
OBJECTIVES: To describe and evaluate a novel surgical approach to orbital wall reconstruction that uses three-dimensionally (3D) printed templates to mold a customized orbital implant. METHODS: A review was conducted of 11 consecutive patients who underwent orbital wall reconstruction using 3D-printed customized orbital implant templates. In these procedures, the orbital implant was 3D pressed during surgery and inserted into the fracture site. The outcomes of this approach were analyzed quantitatively by measuring the orbital tissue volumes within the bony orbit using computed tomography. RESULTS: All 11 orbital wall reconstructions (6 orbital floor and 5 medial wall fractures) were successful with no post operative ophthalmic complications. Statistically significant differences were found between the preoperative and post operative orbital tissue volumes for the affected orbit (24.00 ± 1.74 vs 22.31 ± 1.90 cm3; P = 0.003). There was no statistically significant difference found between the tissue volume of the contralateral unaffected orbit and the affected orbit after reconstruction (22.01 ± 1.60 cm3 vs 22.31 ± 1.90 cm3; P = 0.182). CONCLUSION: 3D-printed customized orbital implant templates can be used to press and trim conventional implantable materials with patient-specific contours and sizes for optimal orbital wall reconstruction. It is difficult to design an orbital implant that exactly matches the shape and surface of a blowout fracture site due to the unique 3D structure of the orbit. The traditional surgical method is to visually inspect the fracture site and use eye measurements to cut a two-dimensional orbital implant that corresponds to the anatomical structure of the fracture site. However, implants that do not fit the anatomical structure of a fracture site well can cause complications such as enophthalmos, diplopia and displacement of the implant.
OBJECTIVES: To describe and evaluate a novel surgical approach to orbital wall reconstruction that uses three-dimensionally (3D) printed templates to mold a customized orbital implant. METHODS: A review was conducted of 11 consecutive patients who underwent orbital wall reconstruction using 3D-printed customized orbital implant templates. In these procedures, the orbital implant was 3D pressed during surgery and inserted into the fracture site. The outcomes of this approach were analyzed quantitatively by measuring the orbital tissue volumes within the bony orbit using computed tomography. RESULTS: All 11 orbital wall reconstructions (6 orbital floor and 5 medial wall fractures) were successful with no post operative ophthalmic complications. Statistically significant differences were found between the preoperative and post operative orbital tissue volumes for the affected orbit (24.00 ± 1.74 vs 22.31 ± 1.90 cm3; P = 0.003). There was no statistically significant difference found between the tissue volume of the contralateral unaffected orbit and the affected orbit after reconstruction (22.01 ± 1.60 cm3 vs 22.31 ± 1.90 cm3; P = 0.182). CONCLUSION: 3D-printed customized orbital implant templates can be used to press and trim conventional implantable materials with patient-specific contours and sizes for optimal orbital wall reconstruction. It is difficult to design an orbital implant that exactly matches the shape and surface of a blowout fracture site due to the unique 3D structure of the orbit. The traditional surgical method is to visually inspect the fracture site and use eye measurements to cut a two-dimensional orbital implant that corresponds to the anatomical structure of the fracture site. However, implants that do not fit the anatomical structure of a fracture site well can cause complications such as enophthalmos, diplopia and displacement of the implant.
Authors: Daniel C Garibaldi; Nicholas T Iliff; Michael P Grant; Shannath L Merbs Journal: Ophthalmic Plast Reconstr Surg Date: 2007 Nov-Dec Impact factor: 1.746
Authors: Nathan W Blessing; Andrew J Rong; Brian C Tse; Benjamin P Erickson; Bradford W Lee; Thomas E Johnson Journal: Ophthalmic Plast Reconstr Surg Date: 2021 May-Jun 01 Impact factor: 2.011