Socket, Anophthalmia and Orbito-facial Prosthesis Service; Ophthalmic Plastic Surgery Service, LV Prasad Eye Institute, Hyderabad, Telangana, India.
Srujana Center for Innovation, LV Prasad Eye Institute, Hyderabad, Telangana, India.
Indian J Ophthalmol. 2018 Nov;66(11):1600-1607. doi: 10.4103/ijo.IJO_472_18.
To describe the outcomes of a patient-specific implant (PSI), fabricated using a three-dimensional (3D) printed orbital template and placed in the basin of the inferior orbital fissure to correct inferotemporally migrated spherical orbital implant.
This is a single-center, prospective, consecutive, interventional, case series of six patients, with non-porous, spherical, orbital implant migration that underwent implant recentration surgically with a novel technique. Migration was subclassified either as decentration that did not affect the prosthetic retention or as displacement that affected the prosthetic retention in the eye socket. Only implant displacements were treated. The primary outcome measure was centration of the implant clinically and radiologically, with ability to retain the prosthesis.
At a mean follow-up of 21 months, all six orbital spherical implants remained centered. There were no cases of extrusion, exposure, or migration of either implants. There were no cases of PSI displacement. Additional procedures to optimize the aesthetic outcome of the customized ocular prosthesis (COP) required were simultaneous fornix formation suture in three patients, subsequent fornix formation with mucus membrane graft in two patients, and levator resection and sulcus hyaluronic acid gel injection in one patient each. The mean PSI implant weight was 2.66 ± 0.53 g. The mean COP weight was 2.2 ± 0.88 g postoperatively. The median patient satisfaction with the procedure was 9 on 10.
A 3D printing-assisted PSI placed in the basin of the inferior orbital fissure allows recentration of the migrated implant over a follow-up of 21 months without complications.
描述使用三维（3D）打印眶模板制作的个体化植入物（PSI）的结果，将其置于下眶裂窝中以矫正下眶外侧移位的球形眶植入物。
这是一项单中心、前瞻性、连续、介入性、病例系列研究，纳入了 6 例患者，他们的非多孔性球形眶植入物发生了迁移，通过一种新的技术进行了手术重新定位。将迁移分为影响假体保留的偏心移位和不影响假体保留的偏心移位。仅处理假体移位。主要的观察指标是植入物的临床和影像学定位，以及保留假体的能力。
在平均 21 个月的随访中，6 例眶部球形植入物均保持居中。无植入物脱出、暴露或迁移的病例。无 PSI 移位的病例。为了优化定制眼假体（COP）的美学效果，需要同时进行 3 例患者的穹窿成形缝线、2 例患者的黏液膜移植后的穹窿成形术，以及 1 例患者的提上睑肌切除术和睑沟透明质酸凝胶注射。PSI 植入物的平均重量为 2.66±0.53g，术后 COP 的平均重量为 2.2±0.88g。6 例患者的手术满意度中位数为 10 分中的 9 分。
在下眶裂窝中放置的 3D 打印辅助 PSI 可以在 21 个月的随访中矫正迁移的植入物，没有并发症。
