title: The Role of Computer-Assisted Technology in Post-Traumatic Orbital Reconstruction: A PRISMA-driven Systematic Review.
abstract: Post-traumatic orbital reconstruction remains a surgical challenge and requires careful preoperative planning, sound anatomical knowledge and good intraoperative judgment. Computer-assisted technology has the potential to reduce error and subjectivity in the management of these complex injuries. A systematic review of the literature was conducted to explore the emerging role of computer-assisted technologies in post-traumatic orbital reconstruction, in terms of functional and safety outcomes. We searched for articles comparing computer-assisted procedures with conventional surgery and studied outcomes on diplopia, enophthalmos, or procedure-related complications. Six observational studies with 273 orbits at a mean follow-up of 13 months were included. Three out of 4 studies reported significantly fewer patients with residual diplopia in the computer-assisted group, while only 1 of the 5 studies reported better improvement in enophthalmos in the assisted group. Types and incidence of complications were comparable. Study heterogeneities limiting statistical comparison by meta-analysis will be discussed. This review highlights the scarcity of data on computer-assisted technology in orbital reconstruction. The result suggests that computer-assisted technology may offer potential advantage in treating diplopia while its role remains to be confirmed in enophthalmos. Additional well-designed and powered randomized controlled trials are much needed.
authors.affiliation: Department of Ophthalmology, Tuen Mun Eye Center and Tuen Mun Hospital, Hong Kong.|Department of Ophthalmology and Visual Sciences, the Chinese University of Hong Kong, Hong Kong.
authors.forename: Kelvin H
authors.initials: KH
authors.lastname: Wan
authors.affiliation: Department of Ophthalmology and Visual Sciences, Prince of Wales Hospital.|Alice Ho Liu Ling Nethersole Hospital, Hong Kong.|Department of Ophthalmology and Visual Sciences, the Chinese University of Hong Kong, Hong Kong.
authors.forename: Kelvin K L
authors.initials: KK
authors.lastname: Chong
authors.affiliation: Department of Ophthalmology and Visual Sciences, Prince of Wales Hospital.|Alice Ho Liu Ling Nethersole Hospital, Hong Kong.|Department of Ophthalmology and Visual Sciences, the Chinese University of Hong Kong, Hong Kong.
authors.forename: Alvin L
authors.initials: AL
authors.lastname: Young
mesh_terms: D006801:Humans; D009915:Orbit / Q000293:injuries* / Q000601:surgery*; D009916:Orbital Diseases / Q000175:diagnosis / Q000209:etiology* / Q000601:surgery*; D019651:Plastic Surgery Procedures; D025321:Surgery, Computer-Assisted / Q000009:adverse effects / Q000379:methods*; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome; D014947:Wounds and Injuries / Q000150:complications*