Abstract
OBJECTIVE: To evaluate the efficacy and safety of endoscopic navigation-guided 3D printing combined with absorbable materials for individualized minimally invasive reconstruction of orbital blowout fractures, comparing outcomes to preformed titanium mesh controls to validate clinical value in achieving anatomical reduction, improving visual function, and reducing complications. METHODS: This retrospective study enrolled 87 patients receiving absorbable implants (Trial Group) and 19 patients treated with preformed titanium mesh (Control Group). Preoperative CT scans were processed using Mimics 21.0 and Geomagic Studio 12.0 for 3D reconstruction, generating patient-specific guides and 3D-printed orbital models based on mirror-imaged healthy orbits. In the Trial Group, absorbable plates were thermo-molded using surgical guides and implanted; controls underwent titanium mesh trimming followed by screw fixation. Statistical analyses employed SPSS 26.0 with Python-automated covariate control: propensity score weighting (PSW) balanced baseline covariates (gender, age, fracture extent; SMD < 0.1 confirmed balance). Longitudinal continuous data (exophthalmos difference, logMAR BCVA) were analyzed via generalized estimating equations (GEE) modeling time-group interactions, while ordinal outcomes (diplopia severity, ocular motility restriction) used weighted ordinal logistic regression to compute marginal effects. All analyses controlled for timepoint interactions with statistical significance defined at α = 0.05. RESULTS: The absorbable material group demonstrated superior diplopia resolution (residual rate: 9.2% vs. 31.6%, P = 0.018) with significant long-term recovery interaction (β = 1.59, P = 0.039). Both groups showed significant time-dependent improvements in ocular motility and exophthalmos (P < 0.001), though intergroup differences were non-significant. Trial group BCVA improved an additional 42% at 6 months (interaction β = 0.05, P = 0.028). No implant-related complications (infection/displacement) occurred in the absorbable group. CONCLUSION: Endoscopic navigation-guided 3D printing with absorbable materials enables precise, individualized orbital reconstruction, significantly improving diplopia and visual acuity with superior safety, strongly supporting clinical adoption.