Use of 3D Printed Models to Create Molds for Shaping Implants for Surgical Repair of Orbital Fractures

Rationale and Objectives: Surgical repair of an isolated orbital fracture requires anatomically accurate implant shape and placement. We describe a three-dimensional (3D) printing technique to customize the shape of commercially available absorbable implants. Materials and Methods: We reviewed our early experience with three cases in which 3D printed molds were utilized for fracture repair. The institution's medical records were reviewed to assess operative time for orbital floor blow-out fracture repairs. Thin section computed tomography (CT) images were loaded into a clinical 3D visualization software, and stereolithography models were created. The models were loaded into stereolithography editing software in which the nonfractured side was mirrored and overlaid with the fractured side. Sterilizable 3D printed molds were created using the fracture images as well as the virtual mirrored images. The molds were taken to the operating room and used to shape a customized orbital implant for fracture repair, using off-the-shelf bioabsorbable implants. Results: The three patients treated using 3D printed molds had excellent outcomes, with decreased postoperative edema and rapid resolution of ocular misalignment/strabismus. Surgical times were decreased from an average of 93.3 minutes using standard implants to 48.3 minutes following adoption of 3D printed molds. Conclusion: Three-dimensional printed models can be used to create molds for shaping bioabsorbable implants for customized surgical repair, improving fit, reducing tissue handling and postoperative edema, and reducing surgical times.