Physicians Save 13-Year-Old's Sight with 3D-Printed Implant

Samir Amash, a 13-year-old from Jisr az-Zarqa, was rushed to the Pediatric Emergency Room at Hillel Yaffe Medical Center suffering from severe swelling, extensive bruising beneath the eye and intense pain after an iron rod penetrated his eye during a dispute with another child. 

Upon receiving the CT results, the physicians recognized that this was a complex fracture, particularly serious given his young age, at which the eye socket had only recently completed its development. Due to the fracture, the muscle and fatty tissue surrounding the eyeball had collapsed and prolapsed into the sinus cavity. 

"In these types of fractures of the orbital floor, we don't always rush to intervene surgically, however in the case of a 13-year-old, this was an emergency that required immediate intervention to prevent irreversible damage to his vision and eye movement," said Dr. Lev Chvatinski, a senior physician in the ENT, Head & Neck Surgery Department at Hillel Yaffe. 

Samir Amash at a follow-up appointment at the Hillel Yaffe clinic after surgery

A multidisciplinary team reported to the operating room, including Dr. Shay Keren, an oculoplastic specialist in the Ophthalmology Department, senior physicians from the ENT, Head and Neck Surgery Department at Hillel Yaffe, and Dr. Dekel Shilo, an oral and maxillofacial surgeon from Rambam Medical Center. To ensure maximum accuracy and reconstruction, a custom implant tailored to the anatomical structure of the eye socket was printed on a 3D printer. During the surgery, which lasted approximately 90 minutes, the doctors accessed the area using a delicate surgical approach through the lower eyelid. 

"We had to lift the fat and muscle that were trapped inside the sinus, return them to their original position in the orbital socket, and support them, and do it all without damaging the delicate optic nerves. With fractures like this, you have to stay constantly alert, because if there is true muscle entrapment, there are only a few hours to act before irreversible damage can occur. The fact that we have the capability and the technology allows us to respond quickly and optimally. By performing a CT during surgery, we were able to verify in real time that the implant was positioned at exactly the right angle in the orbital floor," said Dr. Shilo. 

The complex procedure was successful. Samir recovered quickly and was discharged home in just a few days with only mild discomfort, full eye movement and his vision entirely intact. His father, Shawki Amash, thanked the physicians for wonderful care of his son and said, "The violence has to stop. It is unacceptable that a child should be attacked so violently. Fortunately for us, this time it ended without permanent damage, but this must be stopped."