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Patient-Specific Implants in Oculofacial Plastic Surgery.

Thomas S Copperman1, Oluwatobi O Idowu1, Sanjai Jalaj2

  • 1Department of Ophthalmology, University of California San Francisco, San Francisco, California, U.S.A.

Ophthalmic Plastic and Reconstructive Surgery
|July 4, 2020
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Summary

Patient-specific implants (PSIs) effectively reconstruct periocular facial defects, particularly after trauma or tumor resection. These custom implants offer precise restoration of facial skeletal structure and volume, leading to favorable outcomes.

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Area of Science:

  • Plastic Surgery
  • Craniofacial Surgery
  • Biomaterials Engineering

Background:

  • Facial skeletal defects pose significant reconstructive challenges.
  • Patient-specific implants (PSIs) offer a customizable solution for complex anatomical restoration.

Purpose of the Study:

  • To evaluate the utilization of PSIs in periocular facial skeletal reconstruction.
  • To characterize indications, surgical variables, and outcomes associated with PSIs.

Main Methods:

  • Retrospective chart review across three academic centers (2015-2019).
  • Analysis of patient records, radiographic imaging, and operative reports.
  • Inclusion of data from four primary surgeons.

Main Results:

  • Eleven patients (8 female, 3 male; ages 15-63) received PSIs.
  • Common indications included trauma (54.5%) and tumor resection (18.2%).
  • Reconstruction frequently involved the inferior orbital rim and maxilla (63.6%); two infections occurred.

Conclusions:

  • PSIs, utilizing CAD and 3D printing, enable precise reconstruction of complex facial defects.
  • Custom implants address structural deficits and volumetric loss, particularly in the orbital rim and midface.
  • PSIs demonstrate significant benefit for patients with trauma or post-tumor resection defects.