Comparison of Orbital Reconstructive Effect between Customized Orbital Implants Using Three-Dimensional Printed Templates and Conventional Manual-Bending Implants in Blowout Fracture Surgery

Abstract

The aim of the present study was to determine the orbital reconstructive effect of customized orbital implants using three-dimensional (3D) printed templates compared with conventional manual-bending implants using computed tomography (CT)-based orbital volume measurements. This retrospective study reviewed the medical records and 3D-CT images of 90 patients who underwent medial, inferior, or inferomedial orbital wall reconstruction. The selected patients were categorized into two groups: (1) the 3D group that underwent surgery using 3D-printed customized orbital implant templates and (2) the manual group that received a conventional manual technique to mold the implant. The volume discrepancy (VD) was obtained by subtracting the volume of the contralateral unaffected eye from that of the injured eye. Of the 90 patients, 33 and 57 were divided into the 3D and manual groups, respectively. The volumes on the contralateral unaffected side and on the pre- and postoperative injured sides were 22.5 ± 2.9, 23.7 ± 3.0, and 22.3 ± 2.8 cm3 (mean ± SD), respectively, in the 3D group, and 21.5 ± 2.5, 22.7 ± 2.8, and 21.2 ± 2.7 cm3 in the manual group. The postoperative VD did not differ between the 3D (–0.2 ± 0.3 cm3) and manual (–0.3 ± 0.9 cm3) groups (p = 0.794). The volume on the postoperative injured side did not differ significantly from that on the contralateral unaffected side in the 3D group, but these did differ significantly in the manual group. Postoperative VD also increased with the preoperative VD in the manual group (Pearson correlation coefficient = 0.548, p = 0.001), whereas there was no such association in the 3D group. The orbital volume restoration effect had superior surgical outcomes for large fractures using the customized orbital implant with 3D-printed templates compared with manual-bending implants.