Improvements in planning lacrimal surgery using DICOM Horos® viewer 3D images

F J Alañón Fernández; M Alañón Fernández; F Alañón Cárdenas; B Marín González; V Cueva-López

doi:10.1016/j.oftal.2020.12.004

Improvements in planning lacrimal surgery using DICOM Horos® viewer 3D images

Arch Soc Esp Oftalmol (Engl Ed). 2021 Feb 27:S0365-6691(21)00012-5. doi: 10.1016/j.oftal.2020.12.004. Online ahead of print.

[Article in English, Spanish]

Authors

F J Alañón Fernández¹, M Alañón Fernández², F Alañón Cárdenas², B Marín González², V Cueva-López³

Affiliations

¹ Instituto Lacrimal Internacional, Jaén, España. Electronic address: fealfe1@hotmail.com.
² Instituto Lacrimal Internacional, Jaén, España.
³ Universidad de Jaén, Jaén, España.

PMID: 33653582
DOI: 10.1016/j.oftal.2020.12.004

Abstract

Introduction and objective: The individual anatomic variation of the course of the lacrimal duct and surrounding structures requires the thorough knowledge of its three-dimensional configuration in order to perform the surgery in the safest and most efficient way. The aim of this study was to consider virtual surgical planning in order to improve dacryocystorhinostomies.

Methods: Horos® was used as a viewer and manager of DICOM-format images for multiplanar, three-dimensional (3D) reconstruction when planning 148 first-time lacrimal operations and 26 reoperations by laser endonasal and endocanalicular DCRs.

Results: The 3D images of the CT dacryocystography were much better identified than the 2D ones, Horos® showing a statistically significant correlation (P<.0001). Over 98.27% of the images match the programme reconstruction. Less than 1.73% of them showed some discordance due to study distortion. These cases were related to trauma. The intraopearative location of the lacrimal system was very accurate, avoiding complications.

Conclusions: Viewing and studying 3D images, Horos® is a very useful tool for diagnosis and preoperative planning. It is very helpful in complex conditions by marking surgical references, locating the lacrimal sac and controlling the post-operative permeability of the lacrimal system. The information loss produced by the image selection is also avoided. Another great advantage is that the programme is free.

Keywords: Cirugía lagrimal; DICOM viewer; Guided images; Horos®; Imágenes guiadas; Lacrimal surgery; Navegación; Navigation; Realidad virtual; Virtual reality; Visor DICOM.