3D打印眼模型辅助后巩膜加固术的效果观察

Observation on the efficacy of 3D printed eye model assisted posterior scleral reinforcement surgery

目的观察3D打印眼模型辅助高度近视患者后巩膜加固术的临床效果。方法前瞻性病例系列研究。纳入郑州大学第一附属医院2023年2月至2023年9月高度近视患者9例(10眼)。所有患眼术前制作3D打印眼模型,辅助后巩膜加固术中植片定位。在3D打印眼模型上根据后巩膜葡萄肿的大小、形状、面积及植片条带的走行方向制作牛心包植片,缝合固定于术眼相应巩膜壁上。术后随访3~11个月,观察手术前后最佳矫正视力(BCVA,logMAR)、眼压、眼轴长度、眼底情况及相关并发症。结果本研究在3D打印眼模型辅助下,单纯行后巩膜加固术4眼,行后巩膜加固术联合玻璃体视网膜手术6眼。术前BCVA为1.25±0.72,眼轴长度为(31.18±2.63)mm。术后3个月BCVA为0.92±0.51,眼轴长度(30.50±3.12)mm,术前和术后BCVA差异有统计学意义(t=2.54,P=0.032);术前和术后眼轴长度差异无统计学意义(t=1.36,P=0.208)。随访期间无并发症发生。结论3D打印眼模型辅助后巩膜加固术治疗高度近视,可准确定位后巩膜葡萄肿并引导植片植入。

ObjectiveTo observe the clinical efficacy of 3D printed eye models assisted posterior scleral reinforcement in high myopia.MethodsThis was a prospective case series study.Nine patients(10 eyes)with high myopia from Feb.2023 to Sep.2023 in the First Affiliated Hospital of Zhengzhou University were included.All affected eyes were made 3D printed eye models before surgery,and 3D printed eye model assisted posterior scleral reinforcement for graft positioning.Bovine pericardial implants were fabricated on the 3D printed eye model according to the size,shape,and area of the posterior scleral staphyloma and the direction of the implant strips,and were sutured and fixed to the corresponding scleral wall of the operated eyes.Postoperative follow-up ranged from 3 to 11 months.Best-corrected visual acuity(BCVA,logMAR),intraocular pressure,axial length,fundus condition and related complications before and after operation were observed.ResultsIn 9 cases(10 eyes),4 eyes underwent posterior scleral reinforcement alone and 6 eyes underwent posterior scleral reinforcement combined with vitreoretinal surgery with the assistance of 3D printed eye models.Preoperative BCVA was 1.25±0.72,and the axial length was(31.18±2.63)mm.Postoperative BCVA was 0.92±0.51,and the axial length was(30.50±3.12)mm,and the difference in BCVA was statistically significant before and after sugery(t=2.54,P=0.032);the difference in axial length was not statistically significant before and after surgery(t=1.36,P=0.208).No serious related complications occurred during the follow-up period.ConclusionAccurately displaying the surgical operation site and guiding the implant implantation in posterior scleral reinforcement surgery assisted by 3D printed eye model for high myopia has clinical application value in guiding the surgical operation and helping patients to improve their visual function.