Abstract：
OBJECTIVE: This review aims to compare and evaluate the outcomes achieved by integrating technological aids and the influence of different implant designs in the reconstruction of post-traumatic orbital defects.
METHODS: Electronic searches of the MEDLINE, Embase, Cochrane Library, and Google Scholar databases until March 2023 were conducted. Clinical controlled trials, observational studies, cohort studies, and retrospective studies were identified and included. The predictor variables were the integration of technological aids namely, computer-assisted surgical planning, mirror image overlay, and intraoperative navigation with the utilization of different orbital implant designs (standard orbital meshes, preformed implants, prebent implants, and patient-specific implant [PSI]) during post-traumatic orbital reconstruction. The primary outcome variables were orbital volume, diplopia, and enophthalmos. Weighted or mean difference and risk ratios at 95% confidence intervals were calculated, where P ＜ .05 was considered significant and a random effects model was adopted.
RESULTS: This review included 7 studies with 560 participants. The results indicate that the difference in postoperative orbital volume between affected and nonaffected eye showed no statistically significant difference between PSI and prebent group (mean difference, -0.41 P = .28, I2 = 46%). PSI group resulted in diplopia 0.71-fold less than that of the standard orbital mesh group but was not statistically significant (P = .15). Standard orbital mesh group is 0.30 times at higher risk of developing enophthalmos as compared to PSI group (P = .010). The literature suggests PSIs are preferred for patients with large defects (Jaquiéry\'s III-IV), whereas prebent implants are equally effective as PSIs in patients with preserved infraorbital buttress and retrobulbar bulge.
CONCLUSIONS: PSIs are associated with improved outcomes, especially for correcting enophthalmos. The data suggests the potential efficacy of prebent implants and PSIs in orbital volume corrections. There is a lack of randomized studies. This review should serve as a recommendation for further studies to contribute to the existing literature.
METHODS: Electronic searches of the MEDLINE, Embase, Cochrane Library, and Google Scholar databases until March 2023 were conducted. Clinical controlled trials, observational studies, cohort studies, and retrospective studies were identified and included. The predictor variables were the integration of technological aids namely, computer-assisted surgical planning, mirror image overlay, and intraoperative navigation with the utilization of different orbital implant designs (standard orbital meshes, preformed implants, prebent implants, and patient-specific implant [PSI]) during post-traumatic orbital reconstruction. The primary outcome variables were orbital volume, diplopia, and enophthalmos. Weighted or mean difference and risk ratios at 95% confidence intervals were calculated, where P ＜ .05 was considered significant and a random effects model was adopted.
RESULTS: This review included 7 studies with 560 participants. The results indicate that the difference in postoperative orbital volume between affected and nonaffected eye showed no statistically significant difference between PSI and prebent group (mean difference, -0.41 P = .28, I2 = 46%). PSI group resulted in diplopia 0.71-fold less than that of the standard orbital mesh group but was not statistically significant (P = .15). Standard orbital mesh group is 0.30 times at higher risk of developing enophthalmos as compared to PSI group (P = .010). The literature suggests PSIs are preferred for patients with large defects (Jaquiéry\'s III-IV), whereas prebent implants are equally effective as PSIs in patients with preserved infraorbital buttress and retrobulbar bulge.
CONCLUSIONS: PSIs are associated with improved outcomes, especially for correcting enophthalmos. The data suggests the potential efficacy of prebent implants and PSIs in orbital volume corrections. There is a lack of randomized studies. This review should serve as a recommendation for further studies to contribute to the existing literature.
摘要：
目的：这篇综述旨在比较和评估通过整合技术辅助手段以及不同植入物设计在创伤后眼眶缺损重建中的影响所取得的成果。
方法：MEDLINE的电子搜索，Embase,科克伦图书馆,和谷歌学者数据库，直到2023年3月才进行。临床对照试验,观察性研究，队列研究，并确定并纳入回顾性研究.预测变量是技术辅助的集成，即，计算机辅助手术计划，镜像叠加，和术中导航，利用不同的眼眶植入物设计(标准眼眶网格，预制植入物，预弯植入物，和患者特定的植入物[PSI]）在创伤后眼眶重建过程中。主要结果变量是眼眶容积，复视,和眼球内陷.计算95%置信区间的加权或平均差和风险比，其中P＜0.05被认为是显著的，采用随机效应模型。
结果：本综述包括7项研究，有560名参与者。结果表明，受影响和未受影响的眼睛之间的术后眼眶体积差异在PSI和prebent组之间没有统计学上的显着差异（平均差异，-0.41P=.28，I2=46%）。PSI组比标准眼眶网组的复视减少0.71倍，但无统计学意义（P=0.15）。与PSI组相比，标准眼眶网组发生眼球内陷的风险是0.30倍（P=.010）。文献表明，PSIs是大缺陷患者的首选（JaquiéryIII-IV），而预弯植入物在保留眶下支撑和后隆起的患者中与PSIs同样有效。
结论：PSIs与改善的结果相关，尤其是矫正眼球内陷.数据表明预弯曲植入物和PSIs在眼眶容积矫正中的潜在功效。缺乏随机研究。这篇综述应作为进一步研究的建议，为现有文献做出贡献。
方法：MEDLINE的电子搜索，Embase,科克伦图书馆,和谷歌学者数据库，直到2023年3月才进行。临床对照试验,观察性研究，队列研究，并确定并纳入回顾性研究.预测变量是技术辅助的集成，即，计算机辅助手术计划，镜像叠加，和术中导航，利用不同的眼眶植入物设计(标准眼眶网格，预制植入物，预弯植入物，和患者特定的植入物[PSI]）在创伤后眼眶重建过程中。主要结果变量是眼眶容积，复视,和眼球内陷.计算95%置信区间的加权或平均差和风险比，其中P＜0.05被认为是显著的，采用随机效应模型。
结果：本综述包括7项研究，有560名参与者。结果表明，受影响和未受影响的眼睛之间的术后眼眶体积差异在PSI和prebent组之间没有统计学上的显着差异（平均差异，-0.41P=.28，I2=46%）。PSI组比标准眼眶网组的复视减少0.71倍，但无统计学意义（P=0.15）。与PSI组相比，标准眼眶网组发生眼球内陷的风险是0.30倍（P=.010）。文献表明，PSIs是大缺陷患者的首选（JaquiéryIII-IV），而预弯植入物在保留眶下支撑和后隆起的患者中与PSIs同样有效。
结论：PSIs与改善的结果相关，尤其是矫正眼球内陷.数据表明预弯曲植入物和PSIs在眼眶容积矫正中的潜在功效。缺乏随机研究。这篇综述应作为进一步研究的建议，为现有文献做出贡献。
