Precise Postocular Fat Injection To Treat Enophthalmos Under Preoperative Navigation

Objective: through CT measurement and Mimics software analysis,the improvement and clinical significance of postbulbar fat injection on posttraumatic enophthalmos were studied,and the reasonable route,injection site and quantitative method of postbulbar fat injection were explored.Method: In the animal experiment,author chose 12 New Zealand white rabbits which weighed about 3 kilogram.The right side of the each New Zealand white rabbit eye socket as experimental group,the left eye socket as control group.Author first builded enophthalmic model.After mature model were obtained,author harvest from the right side of the rabbit inguinal subcutaneous fat and processed them into fat particles.The fat particles were finally injected into the orbit within the muscle cone,in order to improve enophthalmos.After a 3-month follow-up,the changes in the preoperative and postoperative orbital gross morphology were compared,and the changes in the volume of soft tissue in the orbit and the corresponding indexes of the eye protrusion were analyzed.The postoperative complications were recorded,and the correction effect of fat injection of ball particles on enophthalmos was evaluated(p < 0.05 was considered statistically significant).This study followed in August 2014 to July 2017 in our hospital of 30 patients with enophthalmos clear diagnosis,we analyze the CT imaging data,through the evaluation of preoperative and postoperative protrusion degree changes,the changes of soft tissue volume,satisfaction surveys and complications of follow-up,analyze the current outcome of the current clinical treatment for enophthalmos.Results: although it is possible to correct the deformity of enophthalmos to some extent,the optimal injection site,approach and quantitative method are still being explored.In animal experiments,the CT data of ocular protrusion before and after fat injection showed statistical difference,while there was no statistical difference between the experimental group and the control group in eye protrusion after fat injection.During the 3-month follow-up after the injection of fat pellets,the efficiency of fat filling was 86.2%(±0.078%),and no abnormal eye movements,fat embolism,shock,strabismus,hematoma and other serious complications occurred after the injection of fat pellets into the posterior area from the path of the inferior orbital wall.Conclusion: injection of fat globules via inferior orbital wall is a safe and effective surgical method to correct the orbital deformity caused by enophthalmos.