Outcomes of Orbit Reconstructive Surgery Utilizing 3D-Printed Surgical Guides.

Abstract

The purpose of this study is to assess the impact of patient-specific 3D-printed surgical guides (3DSG) when utilized during post-traumatic orbital reconstructive surgery. Retrospective analysis was conducted of 118 patients who underwent orbital fracture repair at a single institution between January 1, 2018, and July 31, 2024. Inclusion criteria were patients with a unilateral orbital fracture repaired, age over 15, and a postoperative CT scan available. Patients were divided into two groups: those repaired conventionally and those repaired with the use of a 3DSG. Computer-aided design modeling software was utilized to perform volumetric analysis of postoperative CT scans and characterize the volume of repaired and uninjured orbits. Post-reconstructive orbital symmetry was calculated and compared between the groups. The frequency of poor orbital volume restoration, defined as volume difference between sides of ≥ 2 mL, 8%, or both, was also compared. Of 118 patients, 87 were repaired conventionally and 31 were repaired with a 3DSG. Asymmetry between the repaired and unaffected orbital volume was greater in the conventional group (1.35 mL, SD ± 0.95 mL) than in the 3DSG group (0.72 mL, SD ± 0.48 mL), p < 0.0001. The incidence of poor postoperative volume restoration was less common when using a 3DSG (3.23% vs. 19.54%, p = 0.039) and NNT of 7. In this retrospective analysis of a single-center experience, use of patient-specific 3D surgical guides during reconstruction of unilateral orbital fractures was associated with improved postoperative orbital symmetry and likely decreased risk of postoperative complications such as globe malposition. III.