3-D Printing for Ophthalmic Surgery

For surgical applications, 3-D printing “is not the future, it’s the present,” said Andrea A. Tooley, MD, at Sunday’s Spotlight session on Artificial Intelligence and New Technologies for the Ophthalmologist.

An additive technology. 3-D printing is an additive technology in that a thin layer of a liquid polymer is laid down and rapidly cured via UV light; the process is repeated as necessary. The official term for this is stereolithography.

Ophthalmic applications. Ophthalmology has been a little slower than other medical specialties to adopt 3-D printing, but the opportunities are there, Dr. Tooley said. She highlighted the following applications:

• Surgical models. These are used in surgical planning, particularly in cardiology and neurology, Dr. Tooley said. “For very complex cases, you can print the actual anatomy and then practice the surgery beforehand.” She noted that this has potential within ophthalmology not only for education but also for device development. “If you’re interested in creating a new surgical instrument, it’s very expensive to have a prototype created—but you can have it 3-D printed and practice [with it] in the lab.”
• Surgical guides. These are models that you bring into the OR with you; researchers have found that they not only decrease operating time but also increase surgical accuracy. “You don’t have to go back and forth during surgery” to check measurements, Dr. Tooley said, as the model is “perfectly shaped for your patient.” These are particularly helpful for orbital surgery and craniofacial reconstruction, she said.
• Patient-specific implants. “These are custom implants that we are able to make for our patients and are left in the body,” said Dr. Tooley. This has applications for craniofacial reconstruction and ocular prostheses—and opens the door to “3-D printed glaucoma valves or IOLs that are customized for our patients.”

What’s next? Dr. Tooley noted that she is particularly excited about potential applications for bioprinting—printing live cells onto a live matrix. In ophthalmology, that means that “the future will be 3-D printed corneas or even extra tissue that we could use.” —Jean Shaw

Financial disclosures: Dr. Tooley: None.

Read more news from AAO 2019 and the Subspecialty Day meetings.