Department of Ophthalmology, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, People's Republic of China.
Shanghai Key Laboratory of Orbital Diseases and Ocular Oncology, Shanghai, People's Republic of China.
Ophthalmic Plast Reconstr Surg. 2020 May/Jun;36(3):305-310. doi: 10.1097/IOP.0000000000001580.
To describe the use of an image-guided 3-dimensional surgical navigation system for the removal of metallic foreign bodies from the human intraorbital region.
Between January 2016 and June 2019, 30 patients with metallic foreign bodies in the orbital area underwent image-guided 3-dimensional surgical navigational removal at the authors' center, and their data were retrospectively analyzed. Patients' age, gender, complaints, cause of initial injury, location, interval between injury, and surgery were recorded. Preoperative CT scans of the orbits were obtained and used for preoperative planning. The 3-dimensional navigation system was used for intraoperative navigation.
In all 30 patients, the foreign bodies were removed by minimally invasive access without any severe complications. The intraoperative average depth of foreign bodies was 19.98 ± 11.47 mm which was consistent with the depth measured in preoperative planning. The mean length, width, and height of foreign bodies determined in preoperative planning were confirmed by postoperative measurements. There was no significant difference between preoperative and postoperative mean logarithm of Mininal Angle Resolution (logMAR) best-corrected visual acuity. According to the postoperative CT scan, all 30 patients' metallic foreign bodies were successfully removed by surgeries using the surgical navigation system. Most patients who presented with diplopia, eye movement pain, and paresthesia were improved after surgery.
This study demonstrated that computer-assisted image-guided 3-dimensional surgical navigation had the advantages of accurate real-time localization of foreign bodies, minimizing collateral damage, determining the appropriate surgical path, and increasing the successful rate of foreign body retrieval.
描述一种用于从人体眼眶区域取出金属异物的图像引导三维手术导航系统的使用方法。
2016 年 1 月至 2019 年 6 月，作者所在中心对 30 例眶内金属异物患者进行了图像引导三维手术导航切除，对其数据进行回顾性分析。记录患者的年龄、性别、主诉、初次受伤原因、位置、受伤至手术间隔以及手术情况。获取眼眶术前 CT 扫描并用于术前规划。术中使用三维导航系统进行导航。
所有 30 例患者均通过微创入路取出异物，无严重并发症发生。术中异物平均深度为 19.98±11.47mm，与术前规划测量深度一致。术前规划确定的异物的平均长度、宽度和高度与术后测量结果相符。术前和术后最佳矫正视力最小角分辨率（logMAR）均值无显著差异。根据术后 CT 扫描，所有 30 例患者均成功通过手术导航系统取出金属异物。大多数存在复视、眼球运动疼痛和感觉异常的患者术后均得到改善。
本研究表明，计算机辅助图像引导三维手术导航具有准确实时定位异物、最小化副损伤、确定合适手术路径和提高异物取出成功率的优点。
