Initial implementation of surgical guide design utilizing digital medicine for lateral orbital decompression surgery

Area of Science:

• Ophthalmology
• Medical Technology
• Surgical Innovation

Background:

• Thyroid-associated ophthalmopathy (TAO) often requires surgical intervention like lateral orbital decompression.
• Traditional surgical navigation systems may present risks such as cerebrospinal fluid leakage and inadequate bone removal.
• Digital medical technology offers potential for enhanced surgical precision and safety.

Purpose of the Study:

• To evaluate the feasibility and efficacy of custom-designed surgical guides in lateral orbital decompression for TAO patients.
• To compare complication rates and surgical outcomes between patients using digital surgical guides and those using surgical navigation systems.

Main Methods:

• 18 patients with TAO underwent lateral orbital decompression between September 2018 and August 2022.
• Three-dimensional orbital models were created from CT scans using Mimics 21.0 software.
• Custom surgical guides were designed with 3-matic 13.0 and Geomagic Wrap 21.0 software, then 3D printed and sterilized.

Main Results:

• Patients using digital surgical guides (n=9) experienced zero cerebrospinal fluid leakage and no inadequate bone removal.
• In contrast, patients using surgical navigation (n=9) had three cases of cerebrospinal fluid leakage and two of inadequate bone removal (p=0.046).
• Significant postoperative improvements in visual acuity and exophthalmos were observed in severe TAO cases.

Conclusions:

• Digitally designed surgical guides are effective and safe auxiliary tools for lateral orbital decompression.
• This technology reduces intraoperative complications and enhances surgical accuracy and safety.
• Further clinical exploration of digital surgical guides in orbital decompression is warranted.