Repairing Complex Orbital Fractures and Deformities Using Patient-Specific Implants

Feb 21, 2020 1:50 PM


Designs for a customized implant based on computed tomography images of the patient's left eye socket.
3D views of designs for a customized implant based on computed tomography images of the patient's left eye socket.

A Gunshot Wound Patient Experiences an Increased Quality of Life

By Douglas P. Marx, MD

Patient-specific orbital implants are revolutionizing the results we can provide for patients who have experienced significant trauma to the eye sockets. Such trauma often leads to double vision that is very debilitating, as well as significant visual deformities to the eye sockets. We are utilizing patient-specific implants at the Moran Eye Center to provide the best quality care for our patients.

A man in his 30s was brought to the Emergency Department at the University of Utah following a gunshot wound to the face. A computed tomography (CT) scan of the face revealed multiple facial fractures, including eye socket fractures involving the medial walls, orbital floors, and lateral walls. The facial fractures were repaired by our Otolaryngology colleagues with excellent results. Because of the significant amount of trauma to the left eye socket, the patient was noted to have a large disparity between the positioning of the two eyes that was very bothersome to him. Likewise, this asymmetry led to significant double vision, making it difficult for him to perform routine daily activities.

Designs for a customized implant based on computed tomography images of the patient's left eye socket.
CT coronal views of designs for a customized implant based on computed tomography images of the patient's left eye socket.

Using the CT images of the patient's eye sockets, a medical device company created a customized eye socket implant using computer-assisted design and computer-assisted manufacturing.

The patient underwent surgery to place the custom implant into his left eye socket. Following surgery, the positioning of his left eye was noted to be substantially better and comparable to his right side. His double vision resolved, and his ability to perform daily functions has substantially improved.

Discussion of Patient-Specific Orbital Implants

Reconstruction of complex orbital and periorbital deformities can be extremely challenging. Many implants exist that can help repair the eye sockets, but many of these implants fall short in producing optimal results. This report demonstrates the significant contribution patient-specific implants have created in eye socket reconstruction.

Because of the multidisciplinary approach that we take at the Moran Eye Center, we are able to provide the best possible care for patients, utilizing the most up-to-date resources and technologies. Although many patients will not require a customized implant for their repair, this addition to the previously available technologies provides one more important piece to achieving optimal results.

About the Author

Dr. Marx specializes in pediatric and adult oculoplastic and reconstructive surgery, with a particular interest in orbital tumors, eyelid and orbital reconstruction, and congenital disorders.

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