Department of Ophthalmology, Amsterdam Orbital Center, Amsterdam UMC, University of Amsterdam, Meibergdreef 9, Amsterdam, the Netherlands
Department of Ophthalmology, Amsterdam Orbital Center, Amsterdam UMC, University of Amsterdam, Meibergdreef 9, Amsterdam, the Netherlands.
Br J Ophthalmol. 2023 Sep;107(9):1239-1245. doi: 10.1136/bjophthalmol-2021-320882. Epub 2022 Apr 27.
BACKGROUND/AIMS: To evaluate treatment with custom, three-dimensional (3D) printed conformers for socket expansion in congenital microphthalmia and anophthalmia (MICA).
Retrospective analysis of prospective cohort from 2016 to 2020. All children received custom-made 3D-printed conformers increasing in size. We measured height, width, thickness, surface and volume of first and consecutive conformers, as well as horizontal palpebral fissure length (HPF) at start and follow-up visits. We analysed these parameters for severely (<45%) and moderately (>45%-75%) affected children, based on affected axial length on ultrasonography.
We included 18 cases (9 severe, 9 moderate) with a total of 174 conformers (88 severe, 86 moderate) and a mean follow-up of 2.8 years (range 1.3-4.8). The mean relative HPF increased from 77% to 93% with 16/17 cases reaching >80%, and 12/17 cases >90% symmetry. Horizontal and vertical conformer dimensions increased up to 10 months of treatment, with a steeper slope for the severe group (10.5% vs 5.5% for height and 9.0% vs 6.1% for width gain per treatment month, for severe and moderate MICA, respectively). After 10 months of treatment conformer height and width increased only slightly. No serious complications were observed.
3D-design and printing of solid conformers results in highly acceptable horizontal eyelid symmetry in the treatment of congenital MICA. The mean increase in conformer height and width in the first 10 months should be about 170% for moderate and about 200% for severe MICA. The presented conformer size formulas can aid ophthalmologists and ocularists to plan conformer treatment.
背景/目的：评估定制的三维（3D）打印成形器在先天性小眼球症和无眼球症（MICA）中的眼眶扩张治疗效果。
回顾性分析 2016 年至 2020 年的前瞻性队列研究。所有患儿均接受了定制的 3D 打印成形器治疗，尺寸逐渐增大。我们测量了初次和连续使用的成形器的高度、宽度、厚度、表面积和体积，以及初次就诊和随访时的水平睑裂长度（HPF）。我们根据超声检查的受累眼轴长度，将这些参数分为严重（<45%）和中度（>45%-75%）受累患儿进行分析。
共纳入 18 例（9 例严重，9 例中度）患儿，共使用 174 个成形器（88 个严重，86 个中度），平均随访时间为 2.8 年（范围为 1.3-4.8 年）。平均相对 HPF 从 77%增加到 93%，16/17 例患儿达到>80%，12/17 例患儿达到>90%对称。水平和垂直成形器尺寸增加持续至治疗 10 个月，严重组的斜率较大（高度分别增加 10.5%和 5.5%，宽度分别增加 9.0%和 6.1%，中度和重度 MICA 分别为每个治疗月）。治疗 10 个月后，成形器的高度和宽度仅略有增加。未观察到严重并发症。
3D 设计和打印实心成形器可显著提高先天性 MICA 患者的眼睑水平对称性。中度 MICA 患者在前 10 个月内，成形器高度和宽度的平均增加量约为 170%，严重 MICA 患者的平均增加量约为 200%。本文提出的成形器尺寸公式可帮助眼科医生和眼整形医生规划成形器治疗。
