Kühnel T V, Vairaktaris E, Schlegel K A, Neukam F W, Kühnel B, Holbach L M, Nkenke E
Mund-, Kiefer- und Gesichtschirurgische Klinik, Universität Erlangen-Nürnberg, Glückstrasse 11, 91054, Erlangen, Deutschland.
Ophthalmologe. 2008 Jun;105(6):578-83. doi: 10.1007/s00347-007-1585-y.
In the case of displacement of the globe such as enophthalmos induced by trauma, the patient is affected on both counts: function and aesthetics. To prevent double vision or conspicuous asymmetry, exact correction of the globe position is required. The aim of this case report is to demonstrate an intraoperative computer-assisted, non-contact, optical 3D procedure for identification of the globe position to aid in placing the eyeball in the position required in complex reconstruction of the orbital floor. A 33-year-old man presented with a sunken eye on the right side in the horizontal and vertical plane 6 months after having undergone surgery elsewhere for a zygomatico-orbital fracture, also including the orbital floor. The patient was affected by double vision and a noticeable defective globe position. In planning the correction of the globe position, a three-dimensional image of the face with opened eyes was made with the optical sensor. Automatic comparison of symmetry revealed enophthalmos of 4 mm on relative en- and exophthalmometry. The decision was made to lift the orbital floor with a split calvarial bone graft. During surgery the position of the globe was also controlled by the three-dimensional optical technique. At the end of surgery there was exophthalmos of 1 mm. Six weeks after surgery the patient was not affected by any double vision. After 3 and 24 months enophthalmos was 1 mm. This case demonstrates how the non-ionizing, non-contact, optical 3D technique can help in planning, intraoperative transformation, and clinical monitoring to identify the correct position of the corneal vertex in complex orbital floor reconstruction.
在眼球移位的情况下，如外伤引起的眼球内陷，患者在功能和美观两方面都会受到影响。为防止复视或明显不对称，需要精确矫正眼球位置。本病例报告的目的是展示一种术中计算机辅助、非接触式光学三维程序，用于确定眼球位置，以帮助在复杂的眶底重建中将眼球放置在所需位置。一名33岁男性在其他地方接受颧骨眶骨折（包括眶底）手术6个月后，右侧眼睛在水平和垂直平面出现凹陷。患者受复视和明显的眼球位置缺陷影响。在规划眼球位置矫正时，使用光学传感器获取了睁眼时面部的三维图像。对称性自动比较显示相对眼球突出度测量中眼球内陷4毫米。决定采用劈开颅骨骨移植来抬高眶底。手术过程中，也通过三维光学技术控制眼球位置。手术结束时眼球突出1毫米。术后六周患者未受任何复视影响。术后3个月和24个月眼球内陷均为1毫米。本病例展示了非电离、非接触式光学三维技术如何有助于在复杂的眶底重建中进行规划、术中调整以及临床监测，以确定角膜顶点的正确位置。
