This has its own challenges, since the fit will be variable, the process can be time consuming, and the results inconsistent. Previously, this has been treated by hand bending a sheet or using multiple stacked implants. a missing inferior orbital rim), or if an orbital wall is sunken down and a flat implant across it would create a “dead space” (e.g. However, in some cases, flat implants are not desirable, particularly when there is an irregular shape missing (e.g. For use in the orbit, these flat implants have been widely used for decades with success, particularly in patients with isolated single wall fractures where a thin sheet is desirable to prevent globe dystopia. porous polyethylene or titanium) that are uniform but largely flat. The evolution of implants or grafts used in the orbit has evolved from allografts of bone or cartilage (which are of irregular shape and/or volume) to alloplastic materials (e.g. These have been termed “patient specific implants”, or PSI. 1, 2, 3 The newest generation of these implants are custom manufactured using CT scans to mirror image the normal side (if there is one) to the abnormal side and create an implant to eliminate that difference. Some of these are simply trimmed prior to surgery on a model, while others use a mold to press a sheet intraoperatively, while others used hot water baths intraoperatively to shape an implant. Several similar terms are frequently used in the literature which do not specify an exact technique: “3D”, “digital”, “3D printing”, “pre-shaped”. With that moniker, all implants are technically “customized” since they are trimmed intraoperatively and shaped for one patient. A “custom orbital implant” is an imprecise term that comprises a heterogenous number of materials and methods to fashion an implant that is made for an individual.
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