# Long-term stability of ocular function after alloplastic computer-aided design/computer-aided manufacturing reconstruction of posttraumatic orbital defects: a retrospective cohort study

## TL;DR

This study examines the long-term effects of using CAD/CAM implants for reconstructing orbital defects, finding no significant improvement in globe positioning but better motility and visual outcomes.

## Contribution

The study provides new insights into the long-term functional outcomes of CAD/CAM versus standard CAD-based implants in orbital reconstruction.

## Key findings

- CAD/CAM implants did not significantly improve long-term globe positioning compared to standard implants.
- CAD/CAM implants showed better motility and visual acuity outcomes.
- Vertical globe deviation was significantly associated with diplopia.

## Abstract

We investigated the long-term stability of ocular function and eyeball position after posttraumatic orbital reconstruction of patient-specific implants using alloplastic computer-aided design/computer-aided manufacturing (CAD/CAM). In this study, we evaluated the extent to which precise anatomical reconstruction contributes to stable functional and aesthetic outcomes over time.

Between 2010 and 2018, we retrospectively analyzed 69 patients who underwent orbital floor and medial wall reconstruction. The patients were classified into two groups following the implant type: CAD/CAM-manufactured titanium implants and standard CAD-based titanium implants. Long-term follow-up (LTFU) assessments included globe positioning, diplopia, motility, visual acuity, and intraocular pressure. The differences between the two groups were determined using statistical analyses.

Deviations in the sagittal and vertical globe positions persisted after a median follow-up of 56 months in both groups, with no significant differences. Vertical globe deviation is significantly associated with diplopia. Patients with CAD-based implants showed a higher tendency for motility restriction and lower visual acuity than those with CAD/CAM implants. Intraocular pressure was significantly lower in the affected eyes in both groups.

CAD/CAM-designed implants provide improved anatomical reconstruction; however, they do not significantly improve long-term globe positioning than CAD-based implants. However, they may also contribute to improved motility and visual outcomes. A close interdisciplinary approach involving ophthalmologists is important for optimizing treatment planning and postoperative assessments.