An Individualized 3-Dimensional Designed and Printed Conformer After Dermis Fat Grafting for Complex Sockets

Purpose: To introduce a novel technique to design individually customized conformers for postenucleation sockets with dermis fat implants. Methods: We use a 3-dimensional scan of the frontal face/orbit and eyelid contour to design an individualized conformer. This polymethylmetacrylate printed conformer is adapted to patients' socket, palpebral fissures, horizontal eyelid aperture, curvature of the eyelids, and mean diameter of patients' contralateral eye. Sutures through holes in the inferior part of the conformer and in the extension can be placed to fixate the conformer and anchor fornix deepening sutures. Results: A correct fitting conformer can be printed and attached to the socket and eyelids. The shape of this conformer can be used subsequently postsurgically to design the ocular prosthesis. Conclusion: Presurgical planning is important to anticipate for a functional socket to adequately fit an artificial eye. The presented technique using 3-dimensional imaging, designing, and printing promises to prevent conformer extrusion and forniceal shortening. Accepted for publication February 15, 2018. Supported by ODAS Foundation, Delft, The Netherlands. The sponsor or funding organization had no role in the design or conduct of this research. The authors have no financial or conflicts of interest to disclose. Supplemental digital content is available for this article. Direct URL citations appear in the printed text and are provided in the HTML and PDF versions of this article on the journal's website (www.op-rs.com.). Ms. Mourits and Mr. Remmers contributed equally to this article. Address correspondence and reprint requests to Department of Ophthalmology, VU University Medical Center, De Boelelaan 1117, 1081 HV, Amsterdam, The Netherlands. E-mail: D.mourits@vumc.nl © 2018 by The American Society of Ophthalmic Plastic and Reconstructive Surgery, Inc., All rights reserved.