Israeli Doctors Combine AR with 3D Printing in Novel Eye Socket Surgical Repair Procedure

Surgeons at the Israeli Galilee Medical Center (GMC) have developed a novel 3D printing and Augmented Reality (AR)-based technique for treating eye socket fracture patients.

In what’s believed to be a world’s first, the clinicians fabricated a metal implant for a face injury sufferer, then used Microsoft HoloLens glasses to accurately place it within their skull. The procedure proved to be both rapid and precise, paving the way for improved patient outcomes, and reducing the need for follow-up surgeries.

“Utilizing a 3D printer and AR resulted in both a particularly accurate execution of the operation, and a significant reduction in time,” Professor Samer Srouji, who led the procedure, told The Jersualem Post. “This technology will contribute to improved clinical outcomes and reduce repeated imaging and surgeries.”

The novel AR-based approach

Utilizing additive manufacturing to create customizable facial implants is, in itself, not a novel concept. Technicians at the UK’s NHS have deployed 3D printing within facial reconstruction for at least four years, while scientists at Texas A&M University have trialed stem cell-based implants that better encourage cranial regeneration.

Similarly, the HoloLens has been around since 2016, and developers such as Trimble have created software for the device that provides it with 3D modeling capabilities. The technologies are therefore not particularly new, but in combining them, the GMC doctors have uncovered a method of using modeling the procedure.

The clinicians’ innovation was necessitated by the arrival of a 31-year-old man on their ward, who had sustained a fractured left eye socket. In order to treat the patient without impairing the aesthetics of his eyes, the doctors chose to work with partners at the Sheba Medical Center (SMC), and trial their innovative new surgery.

3D printing and surgical success

Before the procedure, the surgeons conducted CT scans of the patient, and used them to reconstruct the shape of the floor of his eye socket. This process allowed the doctors to build a 3D model of the skull, to ‘project’ the healthy side onto the damaged bone, and ultimately to accurately 3D print a customized titanium graft.

During the operation itself, one of the doctors wore the AR glasses, which were connected to a computer program containing both a model of the patients’ skull, and the metal plate. Subsequently, through the HoloLens, the surgeon was able to place the 3D model over the man’s head, and use it as a virtual guide in real-time.

Leveraging their holographic approach, the GMC team were able to reduce the time required for surgery down to just an hour and a half. Additionally, after the patient had been allowed to recover, further CT scans were conducted which showed that the transplant had been conducted optimally, and he was eventually discharged.

According to Srouji, the project’s success is down to the continued development of the GMC’s 3D Point of Care unit. Despite the ongoing impact of COVID-19, the GMC and SMC have continued to experiment with 3D technologies there, and both have committed to experimenting within new types of surgeries in the years ahead.

Advances in additive bone materials

Given that 3D printing is now often deployed within surgical applications, many scientists have turned their attention to creating more biocompatible implants that better help patients to heal.

Scientists from the Skolovo Institute of Science and Technology (Skoltech), for instance, have developed a novel method of 3D printing personalized ceramic bone grafts. The team’s simulation-based approach has yielded designs with larger pores, potentially enabling them to be easily fused with organic tissues.

Researchers from the Dutch Delft University of Technology, meanwhile, have found that 3D printed biodegradable magnesium scaffolds could be used to treat certain critical bone defects. The biomaterials were found to be capable of degrading naturally inside the body, while stimulating bone regeneration at the same time.

Elsewhere, a team from the Animal Health Trust (AHT) and University of East Anglia (UEA) have developed 3D printed scaffolds to support bone regeneration in horses. By injecting stem cells into their additive devices, the scientists were able to create novel osteoblasts, that could be used within veterinary fracture repair surgeries.

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Author: Paul Hanaphy