Intraoperative noncontact, nonionizing, optical 3D exophthalmometry during repositioning of dislocated globes: first results.
OBJECTIVE
This study reports on the intraoperative use of noncontact, nonionizing, optical 3-dimensional (3D) exophthalmometry during the repositioning of dislocated globes as a result of trauma.


METHODS
Ten patients (4 female, 6 male, 41.4+/-15.2 years) with a relative enophthalmos of the globe as a result of zygomatic fractures were included in the study. Preoperatively, en- and exophthalmometry data were assessed from axial CT slices and optical 3D imaging. 3D data were analyzed twice for the assessment of measurement errors. Intraoperatively, optical en- and exophthalmometry was carried out to control the globe position. Surgery was considered successful when the relative en- or exophthalmos no longer exceeded 2 mm. Optical 3D en- and exophthalmometry data were reassessed 5 days and 3 months after surgery.


RESULTS
Method error was 0.184 mm for optical 3D en- and exophthalmometry. The preoperatively assessed en- and exophthalmometry data determined from axial CT scans and from optical 3D images did not differ significantly statistically (P=.538). When the preoperative en- and exophthalmometry data were compared to the values assessed at the end of surgery, a significant improvement in globe position was found (P=.005). Although a relative en- or exophthalmos of 2 mm was not exceeded in any of the patients 3 months after surgery, en- and exophthalmometry data differed significantly statistically from the data assessed at the end of the operation (P=.005).


CONCLUSIONS
Intraoperative optical en- and exophthalmometry is an effective means to support the surgeon in objectively optimizing the globe position with small measurement errors.
Kramer
Manuel
M
Department of Oral and Maxillofacial Surgery, University of Erlangen-Nuremberg, Erlangen, Germany.
Maier
Tobias
T
Benz
Michaela
M
Holbach
Leonard M
LM
Häusler
Gerd
G
Neukam
Friedrich Wilhelm
FW
Nkenke
Emeka
E
D000328:Adult; D003941:Diagnostic Techniques, Ophthalmological; D015841:Enophthalmos / Q000175:diagnosis / Q000209:etiology; D005094:Exophthalmos / Q000175:diagnosis* / Q000209:etiology; D005260:Female; D006801:Humans; D021621:Imaging, Three-Dimensional / Q000379:methods; D007430:Intraoperative Care; D008297:Male; D009917:Orbital Fractures / Q000150:complications; D015203:Reproducibility of Results; D015051:Zygomatic Fractures / Q000150:complications