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Three-Dimensional Reconstruction of Orbital Fractures
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Patient-specific Implants for Orbital Fractures: A Systematic Review
Dominic I Maher1, Anthony J Hall1,2, StellaMay Gwini3
1Department of Ophthalmology, Alfred Hospital, Melbourne, Victoria, Australia.
Ophthalmic Plastic and Reconstructive Surgery
|November 9, 2021
Summary
Patient-specific implants (PSIs) effectively repair orbital fractures, improving outcomes like diplopia and enophthalmos. However, these custom implants show comparable results to conventional methods, without offering a definitive advantage.
Area of Science:
- Ophthalmology
- Plastic Surgery
- Biomedical Engineering
Background:
- Orbital fractures are common and complex facial injuries.
- Ophthalmic complications necessitate careful surgical repair.
- Patient-specific implants (PSIs) are increasingly utilized for orbital wall reconstruction.
Purpose of the Study:
- To systematically review the current evidence on custom-made orbital wall implants (PSIs).
- To evaluate the efficacy and outcomes of PSIs in orbital fracture repair.
Main Methods:
- A comprehensive literature search was conducted from January 2010 to September 2021.
- Included studies involved human subjects with orbital fractures repaired using PSIs.
- Data on PSI fabrication methods and postoperative outcomes were analyzed.
Main Results:
- Fifteen articles were included, categorizing PSIs by fabrication: manual molding (53%), direct 3D printing (27%), or 3D-printed templates (20%).
- Postoperative diplopia and enophthalmos rates improved across all PSI techniques.
- Orbital volumes were reduced post-surgery, with outcomes comparable to conventional implants.
Conclusions:
- Patient-specific implants (PSIs) can accurately and safely repair orbital fractures.
- The outcomes achieved with PSIs are comparable to those of conventional orbital implants.
- PSIs do not demonstrate a definitive benefit over traditional methods for orbital fracture repair.
