Application Of 3D Printing Personalized Preformed Titanium Mesh In The Repair Of Complex Orbital Fracture

Objective:To investigate the application of 3D printing personalized preformed titanium mesh in the reconstruction of complex orbital fracture.Methods:Choice in September 2018-June 2020 in Hunan Province People’s Hospital of ophthalmology and implementation of fracture repair compound orbital fracture patients with a total of 30 patients(30 eyes).They were divided into 2 groups according to surgical methods.The control group consisted of 17 patients(17 eyes)who received conventional surgery,and the experimental group consisted of 13 patients(13 eyes)who received 3D printing assisted surgery.The patients were followed up for 6 months to compare the difference of orbital volume,the difference of exophthalmos,the cure rate of diplopia,the operation time and the incidence of postoperative complications after operation between the two groups.Results:1.Orbital volume: Orbital volume difference(ml): Orbital volume difference = orbital volume of the affected eye-orbital volume of the healthy eye.(1)The difference of orbital volume between preoperative and postoperative eyes in the experimental group was 2.50±0.34 and0.41±0.24,with significant difference(P < 0.05).(2)The difference of orbital volume was 2.32±0.44 and 0.86±0.51 in the control group before and after operation,and the difference was significant(P < 0.05).(3)The difference of orbital volume between the experimental group and the control group was 0.41±0.24 and 0.86±0.51,respectively,and the difference was statistically significant(P < 0.05).2.Exophthalmos:With Hertel exophthalmus measuring degree of exophthalmos.Exophthalmos degree difference = the healthy eye exophthalmos degree-eye exophthalmos degree.(1)The difference of exophthalmos before and after operation in the experimental group was2.28±0.46 and 1.37±0.31,respectively,and the difference was statistically significant(P < 0.05).(2)The difference of exophthalmos before and after operation in the control group was 2.28±0.74 and 1.16±0.29,respectively,with statistical significance(P < 0.05).(3)The difference of exophthalmos between the experimental group and the control group was 1.37±0.31 and1.16±0.29,respectively,and there was no statistical significance between the two groups(P > 0.05).3.Diplopia :(1)In the experimental group,there were statistically significant differences between 2 weeks after surgery and 3 months after surgery,2 weeks after surgery and 6 months after surgery(P < 0.05),while there were no statistically significant differences between 3 months after surgery and 6 months after surgery(P > 0.05);(2).In the control group,there were statistically significant differences between 2 weeks after surgery and 3 months after surgery,2 weeks after surgery and 6months after surgery(P < 0.05),while there were no statistically significant differences between 3 months after surgery and 6 months after surgery(P > 0.05).(3)Six months after operation,the cure rate of the experimental group was 69.2%,and that of the control group was 58.8%.There was no statistical significance between the two groups(P > 0.05).4.Operation time :The average operation time of the experimental group was 132.08±30.64min;(2)The average operation time of the control group was 166.18±22.83 min.(3)There was a statistically significant difference in the duration of operation between the two groups(P < 0.05).5.Postoperative complications: There was no significant change in visual acuity between the two groups before and after operation.The experimental group had 1 case of endophthalmic invagination,while the control group had 2 cases of mild eyelid ectropion and 1 case of endophthalmic invagination.There were no serious complications such as titanium mesh exposure,displacement,rejection or infection.Conclusion:The application of 3D printing personalized titanium mesh to repair complex orbital fracture has the characteristics of high precision,good effect and short time consumption.It can accurately reconstruct the orbital morphology,restore the orbital volume,and improve the endophthalmias and diplopia.