title: Low-Cost 3D Printing Orbital Implant Templates in Secondary Orbital Reconstructions.
abstract: OBJECTIVE
  Despite its increasing use in craniofacial reconstructions, three-dimensional (3D) printing of customized orbital implants has not been widely adopted. Limitations include the cost of 3D printers able to print in a biocompatible material suitable for implantation in the orbit and the breadth of available implant materials. The authors report the technique of low-cost 3D printing of orbital implant templates used in complex, often secondary, orbital reconstructions.
  
  
  METHODS
  A retrospective case series of 5 orbital reconstructions utilizing a technique of 3D printed orbital implant templates is presented. Each patient's Digital Imaging and Communications in Medicine data were uploaded and processed to create 3D renderings upon which a customized implant was designed and sent electronically to printers open for student use at our affiliated institutions. The mock implants were sterilized and used intraoperatively as a stencil and mold. The final implant material was chosen by the surgeons based on the requirements of the case.
  
  
  RESULTS
  Five orbital reconstructions were performed with this technique: 3 tumor reconstructions and 2 orbital fractures. Four of the 5 cases were secondary reconstructions. Molded Medpor Titan (Stryker, Kalamazoo, MI) implants were used in 4 cases and titanium mesh in 1 case. The stenciled and molded implants were adjusted no more than 2 times before anchored in place (mean 1). No case underwent further revision.
  
  
  CONCLUSIONS
  The technique and cases presented demonstrate 1) the feasibility and accessibility of low-cost, independent use of 3D printing technology to fashion patient-specific implants in orbital reconstructions, 2) the ability to apply this technology to the surgeon's preference of any routinely implantable material, and 3) the utility of this technique in complex, secondary reconstructions.
authors.affiliation: *Department of Ophthalmology, Ophthalmic Plastic and Reconstructive, and Orbital Surgery Division, Columbia University Medical Center, †Department of Ophthalmology, New York University Langone Medical Center, Institute of Reconstructive Plastic Surgery, ‡Department of Ophthalmology, New York-Presbyterian/Weill Cornell Medical Center, and §Department of Ophthalmology, Manhattan Eye Ear and Throat Hospital, New York, New York, U.S.A.
authors.forename: Alison B
authors.initials: AB
authors.lastname: Callahan
authors.forename: Ashley A
authors.initials: AA
authors.lastname: Campbell
authors.forename: Carisa
authors.initials: C
authors.lastname: Petris
authors.forename: Michael
authors.initials: M
authors.lastname: Kazim
mesh_terms: D002648:Child; D003365:Costs and Cost Analysis; D006801:Humans; D008297:Male; D008875:Middle Aged; D009915:Orbit / Q000000981:diagnostic imaging / Q000601:surgery*; D009917:Orbital Fractures / Q000175:diagnosis / Q000191:economics / Q000601:surgery*; D020273:Orbital Implants / Q000191:economics*; D066330:Printing, Three-Dimensional / Q000191:economics*; D019651:Plastic Surgery Procedures / Q000191:economics / Q000379:methods*; D012189:Retrospective Studies; D014057:Tomography, X-Ray Computed