“ Initial experience with augmented reality for treatment of an orbital floor fracture – A Technical Note ”

Abstract

The marked developments in the fields of 3D planning and printing in the last few decades, have enabled the application of virtual surgical planning (VSP) toward personalization of surgical procedures and implants. Augmented reality superimposes digital content on the real-world reality. The aim of this technical note was to introduce the use of AR to evaluate and guide the insertion and positioning of a patient specific implant (PSI) for orbital floor blow-out fracture reconstruction. A 31-year-old, healthy male was injured and suffered from left orbital floor blow-out fracture. DICOM images of the CT scan were obtained for segmentation and for VSP, PSI design and 3D Printing. Patients’ file with the 3D objects was uploaded to AR software. The patient's left orbital floor was approached via the trans-conjunctival incision, PSI titanium plate was set in place and using AR Special head-mounted displays (HoloLens 1, Microsoft) the correct planned position of the plate was confirmed. The post-operative CT scan showed a <0.3 mm discrepancy in all axes of the plate in relation to the planned position. AR application in medicine and in maxillofacial surgery bears great potential, However, further investigation of this technology is required