Feasibility of Magnetic Levator Prosthesis Frame Customization Using Craniofacial Scans and 3-D Printing.
Feasibility of Magnetic Levator Prosthesis Frame Customization Using Craniofacial Scans and 3-D Printing.
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DOI：
10.1167/tvst.11.10.34
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发表时间：
2022-10-03
影响因子：
3
通讯作者：
Paschalis, Eleftherios I.
中科院分区：
文献类型：
--
作者：
Houston, Kevin E.;Paschalis, Eleftherios I.
目的：探讨磁性提上睑肌假体（MLP）非手术治疗重度上睑下垂的可行性。曾经使用过非定制MLP的单眼或双眼严重上睑下垂（模糊视觉轴）的参与者（n = 8）使用智能手机应用程序进行颅面扫描，以生成定制MLP框架。在受影响的眼睑上贴上磁性粘合剂。定制的MLP框架在受影响的眼睑上方的眉毛附近放置一个圆柱形磁铁，将其悬浮在磁场中，同时仍然允许眨眼。眼镜磁铁可以手动旋转，通过磁场的角度平移提供可调节的力。记录安装成功和舒适度，并在办公室使用20分钟和在家使用一周后通过视频帧测量睑间裂（IPF）。偏好被记录，定制与非定制。总体而言，88%的患者（7/8）成功适应了中位9/10的舒适度（四分位间7-10）和中位2.3 mm（1.3-5.0）的上睑下垂改善；P = 0.01)。精确二项检验表明，在80%的幂次下，真实群体成功率显著大于45% （P = 0.05）。五名参与者将定制的MLP带回家一周，只有一例轻度结膜红肿，未经治疗就消失了。最高至最低的力调节导致中位IPF调整1.5 mm（0.8至2.7;P = 0.06）。所有的首选自定义框架。使用基于智能手机应用程序的颅面扫描三维定制MLP框架生成方法是临床部署MLP的可行方法。为MLP定制框架生成的第一个演示。
To determine the feasibility of a custom frame generation approach for nonsurgical management of severe blepharoptosis with the magnetic levator prosthesis (MLP). Participants (n = 8) with severe blepharoptosis (obscuring the visual axis) in one or both eyes who had previously been using a non-custom MLP had a craniofacial scan with a smartphone app to generate a custom MLP frame. A magnetic adhesive was attached to the affected eyelid. The custom MLP frame held a cylindrical magnet near the eyebrow above the affected eyelid, suspending it in the magnetic field while still allowing blinking. The spectacle magnet could be rotated manually, providing adjustable force via angular translation of the magnetic field. Fitting success and comfort were recorded, and interpalpebral fissure (IPF) was measured from video frames after 20 minutes in-office and one-week at-home use. Preference was documented, custom versus non-custom. Overall, 88% of patients (7/8) were successfully fitted with a median 9/10 comfort (interquartile 7–10) and median ptosis improvement of 2.3 mm (1.3–5.0); P = 0.01). Exact binomial testing suggested, with 80% power, that the true population success rate was significantly greater than 45% (P = 0.05). Five participants took the custom MLP home for one week, with only one case of mild conjunctival redness which resolved without treatment. Highest to lowest force modulation resulted in a marginally significant median IPF adjustment of 1.5 mm (0.8 to 2.7; P = 0.06). All preferred the custom frame. The three-dimensional custom MLP frame generation approach using a smartphone app–based craniofacial scan is a feasible approach for clinical deployment of the MLP. First demonstration of customized frame generation for the MLP.
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