Using Computers to Improve Eye Socket Fracture Surgeries

Eye socket fractures commonly occur after traumatic injuries to the face such as motor vehicle accidents, assaults, and falls. For many reasons, they are among the most complex fractures to surgically reconstruct. For example, precise surgical skill is required to avoid damaging the eyelid and the eyes, the surgical work space is narrow, and viewing the entire bone fracture is usually impossible.

Adverse outcomes can result from attempts to surgically reconstruct the eye socket. The most common adverse outcomes include double vision, posterior displacement of the eyeball within the orbit, and decreased eye sensitivity. Some people need a second operation due to complications from the first, which is another adverse outcome. To avoid these complications, it is essential to restore the orbital (eye) bones to their correct structural position. These days, computer assisted technology can aid the surgeon to achieve this goal.

One such computerized technique is referred to as mirror image overlay (MIO). This technique extracts an image of the non-traumatized eye socket on the opposite side of the face and superimposes it onto an image of the fractured eye socket. This provides the surgeon with better information about what the normal bone structure should look like in the individual. It also provides the surgeon real-time feedback of the position and shape of a surgical implant in relation to the correct structural position of the natural bone. The MIO images come from a CT scan. CT scanning is an advanced imaging technique that uses x-rays and computer technology to produce more clear and detailed pictures than a traditional x-ray.

In an upcoming article in JAMA Facial Plastic Surgery, researchers from the University of Washington Harborview Medical Center explain this computerized technique in more detail and report on whether it improves outcomes in 113 consecutive cases of complex orbital fractures. Of these cases, 56 surgeries were performed with the MIO computerized technique and 57 were performed without it. The results of the study showed that surgeries using the computerized technique resulted in decreased double vision and a greatly reduced need for a second surgery. The authors recommended the use of this computerized-assisted surgical technique for complex eye socket fracture repair.

Suggested reading: Face The Facts: The Truth About Facial Plastic Surgery Procedures That Do and Don't Work

Reference: Bly RA, Chang SH, Cudejkova M, Liu JJ, Moe KS. (2013,in press). Computer-Guided Orbital Reconstruction to Improve Outcomes. JAMA Facial Plast Surg.