摘要
目的探讨应用计算机模拟及3D打印等数字化医疗技术进行眼眶骨折个体化修复的可行性及临床效果。方法眼眶骨折患者20例(20只眼),眼球内陷均大于3 mm。所有患者术前行螺旋CT扫描,将所得数据利用Mimics软件进行三维重建,然后通过计算机辅助设计方法进行镜像修复,应用软件布尔运算中的减运算,以镜像后的眶壁数据减去原有的缺损眶壁数据,从而得到与眶壁骨折区域吻合的个性化修复体模型。使用3D打印机制作修复体模型,以修复体模型作为钛网修剪及成形的导板,行眶壁修复成形术。术后观察视力、眼球突出度、眼球运动情况以评价手术效果。结果手术的20例患者术后半年眼球突出度之差均等于或小于2 mm,患者术后均无视力下降,4例残留周边复视。利用此方法制作的修复体模型作为导板,使得钛网与缺损区域的吻合更为精确,并明显缩短了手术中钛网成形的时间。结论计算机辅助设计及3D打印技术可很好的用于眼眶骨折手术设计及钛网的个体化成形,有效提高手术精确性,缩短手术时间,减轻患者经济负担。
Objective To explore the feasibility and clinical effect of individualized repair of orbital fracture with digital medical technology such as computer simulation and 3D printing. Methods There were 20 cases of orbital fracture in 20 eyes,which were all more than 3 mm. All patients underwent spiral CT scan,the data using Mimics software for 3D reconstruction,mirror repair and then through the method of computer aided design,application software in Boolean subtraction,image after orbital data minus the original defect orbital data,so as to obtain personalized prosthesis model consistent with the orbital region fracture. The repair body model was made by 3D printer,and the repair body model was used as the guide plate of the titanium mesh pruning and forming,and the orbital wall repair was performed. Visual acuity,exophthalmos and eye movement were observed after the operation to evaluate the effect of the operation. Results The difference between the 20 cases of the operation was equal to or less than 2 mm for half a year after operation. There were no visual acuity and 4 cases of peripheral diplopia. The repair model made by this method is used as a guide plate,which makes the anastomosis between titanium mesh and defect area more precise,and significantly reduces the time of forming titanium mesh in operation. Conclusions Computer aided design and 3D printing technology can be well applied to orbital fracture surgery design and individualized molding of titanium mesh,effectively improving operation accuracy,shortening operation time and reducing patients＇ economic burden.
作者
赵峰
马景学
高彦军
耿玉欣
井欣
任彦新
Zhao Feng;Ma Jingxue;Gao Yanjun;Geng Yuxin;Jing Xin;Ren Yanxin(Department of Ophthalmology,Nanjing First Hospital,Nanjing Medical University,Nanjing,Jiangsu 210006,China;Department of Ophthalmology,the Second Hospital of Hebei Medical University,Shijiazhuang,Hebei 050051,China)
出处
《临床眼科杂志》
2018年第4期318-320,共3页
Journal of Clinical Ophthalmology
基金
河北省医学科学研究重点课题计划(20090369)
关键词
眼眶骨折
钛网
3D打印
数字化医疗
Orbital fracture
Titanium mesh
3D printing
Digital medical
