Three-dimensional printed surgical guides for keratoma removal in horses using computed tomography or magnetic resonance imaging-based segmentation.
Authors: Biedrzycki Adam H, Morton Alison J, Perez-Jimenez Erik E, Elane George L, Roe Heather A, Trolinger-Meadows Kimberly D
Journal: Veterinary surgery : VS
Summary
# Editorial Summary: 3D-Printed Surgical Guides for Equine Keratoma Removal Keratomas present a genuine surgical challenge due to their location within the hoof capsule and the difficulty in achieving complete removal without excessive bone resection; this case series of five horses explored whether patient-specific 3D-printed guides created from CT or MRI imaging could improve surgical precision and outcomes. Two guides were manufactured from CT data and three from MRI segmentation, with surgeons using the printed models to guide hole-saw placement through the hoof wall directly over the lesion, allowing targeted portal creation rather than blind exploration. All keratomas were successfully extracted intact or with minimal difficulty within 20–90 minutes of surgical time, with CT-based guides requiring no adjustment whilst MRI-derived guides needed minor intraoperative correction for optimal fit. Complete return to previous performance occurred in all cases within 2–4 months, with surgical sites managed conservatively until keratinized granulation tissue sealed the defect. Whilst this technique demonstrates clear advantages in precision, operative efficiency, and healing outcomes, the superior fit accuracy of CT-based guides suggests preference over MRI where imaging options are available, though the case series format warrants larger prospective studies to establish standardised protocols and confirm long-term soundness rates across diverse case presentations.
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Practical Takeaways
- •3D printed surgical guides can significantly reduce keratoma removal time and create smaller, more precise surgical portals compared to traditional approaches
- •CT imaging is preferred over MRI for guide creation due to superior segmentation accuracy and fit without requiring intraoperative adjustments
- •Expected recovery timeline is 2-4 months for return to full performance following guide-assisted keratoma resection
Key Findings
- •3D printed surgical guides created from CT or MRI imaging enabled successful removal of all keratomas as single pieces with surgical times of 20-90 minutes
- •CT-based guides fitted without adjustment; MRI-based guides required minor adjustments with rotary devices for proper fit
- •All horses returned to previous level of performance within 2-4 months postoperatively