Wan Kelvin H, Chong Kelvin K L, Young Alvin L
Department of Ophthalmology, Tuen Mun Eye Center and Tuen Mun Hospital, Hong Kong.
Department of Ophthalmology and Visual Sciences, the Chinese University of Hong Kong, Hong Kong.
Sci Rep. 2015 Dec 8;5:17914. doi: 10.1038/srep17914.
Post-traumatic orbital reconstruction remains a surgical challenge and requires careful preoperative planning, sound anatomical knowledge and good intraoperative judgment. Computer-assisted technology has the potential to reduce error and subjectivity in the management of these complex injuries. A systematic review of the literature was conducted to explore the emerging role of computer-assisted technologies in post-traumatic orbital reconstruction, in terms of functional and safety outcomes. We searched for articles comparing computer-assisted procedures with conventional surgery and studied outcomes on diplopia, enophthalmos, or procedure-related complications. Six observational studies with 273 orbits at a mean follow-up of 13 months were included. Three out of 4 studies reported significantly fewer patients with residual diplopia in the computer-assisted group, while only 1 of the 5 studies reported better improvement in enophthalmos in the assisted group. Types and incidence of complications were comparable. Study heterogeneities limiting statistical comparison by meta-analysis will be discussed. This review highlights the scarcity of data on computer-assisted technology in orbital reconstruction. The result suggests that computer-assisted technology may offer potential advantage in treating diplopia while its role remains to be confirmed in enophthalmos. Additional well-designed and powered randomized controlled trials are much needed.
创伤后眼眶重建仍然是一项外科挑战，需要仔细的术前规划、扎实的解剖学知识和良好的术中判断力。计算机辅助技术有潜力减少这些复杂损伤治疗中的误差和主观性。我们进行了一项系统的文献综述，以探讨计算机辅助技术在创伤后眼眶重建中在功能和安全性结果方面的新兴作用。我们搜索了比较计算机辅助手术与传统手术的文章，并研究了复视、眼球内陷或手术相关并发症的结果。纳入了6项观察性研究，共273个眼眶，平均随访13个月。4项研究中有3项报告计算机辅助组残留复视的患者明显较少，而5项研究中只有1项报告辅助组眼球内陷改善更好。并发症的类型和发生率相当。将讨论限制通过荟萃分析进行统计比较的研究异质性。本综述强调了眼眶重建中计算机辅助技术的数据稀缺性。结果表明，计算机辅助技术在治疗复视方面可能具有潜在优势，而其在眼球内陷治疗中的作用仍有待证实。非常需要更多设计良好且有足够样本量的随机对照试验。
