Department of Ophthalmology, University of California, San Francisco.
Loving Eyes Foundation, San Francisco, California.
JAMA Ophthalmol. 2022 Oct 1;140(10):966-973. doi: 10.1001/jamaophthalmol.2022.3312.
Finding a suitable fit in glasses for pediatric patients with congenital and acquired craniofacial abnormalities is difficult; consequently, these children are at high risk of vision loss secondary to refractive amblyopia as they often have poor adherence to daily glasses wearing. Custom 3-dimensional (3D)-printed glasses may have an improved design and fit, but access is limited by the availability of computed tomography and magnetic resonance imaging (MRI).
To describe a method for using a commercially available smartphone 3D surface imaging (3DSI) technique to capture facial anatomy as a basis for custom glasses design.
DESIGN, SETTING, AND PARTICIPANTS: This quality improvement study analyzes data from a case series in a primary academic center with multiple referral centers throughout the United States. The evaluation included reported fit descriptions from patients with poor glasses adherence due to craniofacial abnormalities.
Key anatomic parameters for glasses fit (face width, distance from ear bridge to nasal bridge, distance from center of pupil to center of nasal bridge, distance from lateral to medial canthus, ear vertical offset, and nasal bridge width) were compared between scans. A 3DSI scan was considered successful if these key parameters could be determined and the difference in measurements was less than 5% between MRI and 3DSI. A second outcome measure included the fit of glasses designed by the 3DSI method as reported by the patient, parent, or guardian.
Measurements of key parameters for glasses fit were similar across MRI and 3DSI scans with a mean (SD) difference of 1.47 (0.79) mm between parameters (range, 0.3-4.60 mm). Among 20 patients aged 1 to 17 years with craniofacial abnormalities, all achieved a successful fit (reporting daily glasses adherence without irritation) as judged by the patient, parent, or guardian. A mean of 1.7 revisions were made from initial prototype to final frame production using 3DSI technology.
This study demonstrated that smartphone-enabled 3DSI coupled with widely available 3D printing technology can produce custom frames with a successful fit for patients with craniofacial anomalies. This accessible and well-tolerated imaging process may have implications for adherence with glasses wearing among patients at risk of vision loss due to amblyopia.
为患有先天性和获得性颅面畸形的儿科患者找到合适的眼镜适配非常困难;因此,这些孩子由于屈光性弱视而有视力丧失的高风险,因为他们通常不遵守日常戴眼镜的规定。定制的 3 维(3D)打印眼镜可能具有改进的设计和适配,但由于计算机断层扫描和磁共振成像(MRI)的可用性有限,因此使用受限。
描述一种使用商用智能手机 3D 表面成像(3DSI)技术捕获面部解剖结构的方法,作为定制眼镜设计的基础。
设计、设置和参与者:本质量改进研究分析了来自美国多个转诊中心的一家主要学术中心的病例系列中的数据。评估包括由于颅面畸形而对眼镜佩戴依从性差的患者的报告适配描述。
眼镜适配的关键解剖参数(脸宽、从耳桥到鼻桥的距离、从瞳孔中心到鼻桥中心的距离、从外侧到内侧眼角的距离、耳垂直偏移量和鼻桥宽度)在扫描之间进行比较。如果可以确定这些关键参数,并且 MRI 和 3DSI 之间的测量值差异小于 5%,则认为 3DSI 扫描是成功的。第二个结果测量包括通过 3DSI 方法设计的眼镜的适配度,由患者、家长或监护人报告。
眼镜适配的关键参数的测量值在 MRI 和 3DSI 扫描之间相似,参数之间的平均(SD)差异为 1.47(0.79)mm(范围,0.3-4.60mm)。在 20 名年龄在 1 至 17 岁之间患有颅面畸形的患者中,所有患者(由患者、家长或监护人判断)都达到了成功的适配(报告每天佩戴眼镜且无刺激)。使用 3DSI 技术,从初始原型到最终框架生产共进行了 1.7 次修订。
本研究表明,智能手机支持的 3DSI 与广泛可用的 3D 打印技术相结合,可以为患有颅面异常的患者生产适配度良好的定制镜框。这种易于访问且耐受性良好的成像过程可能对因弱视而有视力丧失风险的患者佩戴眼镜的依从性产生影响。