Intraoperative Noncontact, Nonionizing, Optical 3D Exophthalmometry During Repositioning of Dislocated Globes: First Results

Purpose

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.

Patients and 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.