Department of Ophthalmology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea.
Department of Ophthalmology, College of Medicine, Hanyang University, Seoul, Republic of Korea.
PLoS One. 2018 Sep 18;13(9):e0204078. doi: 10.1371/journal.pone.0204078. eCollection 2018.
To investigate the performance of a newly developed three-dimensional (3D) biomechanical model in various transposition procedures for correction of complete sixth nerve palsy with educational purpose.
A 3D biomechanical eye model was created using Hyperworks software based on geometry data and the biochemical properties of the eyeball and extraocular muscles. A complete sixth nerve palsy model was achieved via modification of lateral rectus muscle strength. Four different muscle transposition procedures (the Hummelsheim, Jensen, Foster, and muscle union procedures) were set up, and the objective surgical effect of each procedure was calculated using 3D model simulation.
In the 3D simulation, sixth nerve palsy was modeled by rotating the eye 34.16 degrees in the medial direction, consistent with 70 prism diopter (PD) esotropia. In surgical model simulation, the Hummelsheim procedure resulted in a 28 PD reduction of total deviation, the Jensen procedure achieved a 34 PD reduction, the Foster procedure led to a 57 PD reduction, the muscle union procedure yielded a 57 PD reduction in esotropia in sixth nerve palsy.
The 3D simulation provided a consistent model of sixth nerve palsy and objective data excluding the potential for variation of surgical skill. It could also help predict surgical outcomes.
以教育为目的，研究一种新开发的三维（3D）生物力学模型在各种第六神经麻痹矫正转位手术中的性能。
使用基于眼球和眼外肌几何数据和生化特性的 Hyperworks 软件创建 3D 生物力学眼模型。通过修改外直肌强度来实现完全第六神经麻痹模型。设置了四种不同的肌肉转位手术（Hummelsheim、Jensen、Foster 和肌肉联合手术），并通过 3D 模型模拟计算每种手术的客观手术效果。
在 3D 模拟中，通过将眼睛向内侧旋转 34.16 度模拟第六神经麻痹，与 70 棱镜度（PD）内斜视一致。在手术模型模拟中，Hummelsheim 手术导致总偏差减少 28 PD，Jensen 手术减少 34 PD，Foster 手术减少 57 PD，肌肉联合手术导致第六神经麻痹内斜视减少 57 PD。
3D 模拟提供了一种一致的第六神经麻痹模型和客观数据，排除了手术技能变化的潜在影响。它还可以帮助预测手术结果。
