Augmented Reality Assisted Orbital Floor Reconstruction

Abstract

The orbital floor is a thin boney plate that supports the eye and its muscles. When sufficiently large, a fracture of the orbital floor leads to malposition or entrapment of the eye, necessitating surgical reconstruction. To reconstruct the orbital floor, the surgeon must retract the eyeball and dissect deeply through a small incision in order to safely place a synthetic plate beneath the eye, thus replacing the fractured bone. Conventionally, the accuracy of implant placement relies on the surgeon’s expertise. Intraoperative imaging and navigation are rarely used due to their cost and setup times, so erroneous implant positioning is often unrecognized until postoperative imaging. This confers risk to the patient’s eyeball, orbital vasculature, optic nerves, and stereotactic vision. In this work, we develop the workflow and user interface of an Augmented Reality (AR) system to aid surgeons with intraoperative placement of an orbital floor implant and ultimately reduce rates of implant malposition. The preliminary evaluation of workflow and user interface shows good potential of this platform. With improvements in accuracy through advancements in hardware and sensing method, the proposed method can become a successful AR solution to improve clinical performance.