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Workflow and treatment results for computer-aided design and 3D-printed conformer therapy of congenital anophthalmia and microphthalmia
  1. Annabel L W Groot1,
  2. Jelmer S Remmers1,
  3. Birgit I Lissenberg-Witte2,
  4. Simon T J de Meulenaere1,
  5. Duygu Talan1,
  6. Niels P T J Liberton3,
  7. Pim de Graaf4,
  8. Annette C Moll1,
  9. Peerooz Saeed1,
  10. Dyonne T Hartong1
  1. 1Department of Ophthalmology, Amsterdam Orbital Center, Amsterdam UMC, University of Amsterdam, Meibergdreef 9, Amsterdam, the Netherlands
  2. 2Department of Epidemiology and Data Science, Vrije Universiteit Amsterdam, Amsterdam, the Netherlands
  3. 3Department of Medical Technology, Vrije Universiteit Amsterdam, Amsterdam, the Netherlands
  4. 4Department of Radiology and Nuclear Medicine, Amsterdam UMC Locatie VUmc, Amsterdam, the Netherlands
  1. Correspondence to Dr Annabel L W Groot, Department of Ophthalmology, Amsterdam Orbital Center, Amsterdam UMC Locatie AMC, University of Amsterdam, Amsterdam, The Netherlands; annabelgroot{at}gmail.com

Abstract

Background/aims To evaluate treatment with custom, three-dimensional (3D) printed conformers for socket expansion in congenital microphthalmia and anophthalmia (MICA).

Methods Retrospective analysis of prospective cohort from 2016 to 2020. All children received custom-made 3D-printed conformers increasing in size. We measured height, width, thickness, surface and volume of first and consecutive conformers, as well as horizontal palpebral fissure length (HPF) at start and follow-up visits. We analysed these parameters for severely (<45%) and moderately (>45%–75%) affected children, based on affected axial length on ultrasonography.

Results We included 18 cases (9 severe, 9 moderate) with a total of 174 conformers (88 severe, 86 moderate) and a mean follow-up of 2.8 years (range 1.3–4.8). The mean relative HPF increased from 77% to 93% with 16/17 cases reaching >80%, and 12/17 cases >90% symmetry. Horizontal and vertical conformer dimensions increased up to 10 months of treatment, with a steeper slope for the severe group (10.5% vs 5.5% for height and 9.0% vs 6.1% for width gain per treatment month, for severe and moderate MICA, respectively). After 10 months of treatment conformer height and width increased only slightly. No serious complications were observed.

Conclusion 3D-design and printing of solid conformers results in highly acceptable horizontal eyelid symmetry in the treatment of congenital MICA. The mean increase in conformer height and width in the first 10 months should be about 170% for moderate and about 200% for severe MICA. The presented conformer size formulas can aid ophthalmologists and ocularists to plan conformer treatment.

  • orbit
  • prosthesis
  • treatment other
  • child health (paediatrics)
  • cosmesis

Data availability statement

All data relevant to the study are included in the article or uploaded as online supplemental information.

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Data availability statement

All data relevant to the study are included in the article or uploaded as online supplemental information.

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Footnotes

  • Contributors ALWG: data acquisition and organisation, analysis and interpretation, drafting, reviewing and revising of the paper. JSR: provided and cared for study patients, was involved in conformer design and manufacturing, contributed to drafting and review of paper. BIL-W: statistical analysis and data interpretation. PdG, STJdM, DT and NPTJL: data acquisition and organisation. PS and ACM: scientific advisors, reviewing and revising of the paper. DT (guarantor): principal investigator with overall responsibility for the study, study design, data analysis and interpretation, drafting and revising paper .

  • Funding Funding was obtained from the ODAS Stichting, the Netherlands, grant no 2015-33.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.