SlicerOrbitSurgerySim: An Open-Source Platform for Virtual Registration and Quantitative Comparison of Preformed Orbital Plates

Abstract: Poor adaptation of orbital implants remains a major contributor to postoperative complications and revision surgery. Although preformed orbital plates are widely used to reduce cost and operative time compared with customized implants, surgeons currently lack publicly available tools and standardized metrics to quantitatively compare plate fit across vendors, sizes, and patient anatomy. We developed SlicerOrbitSurgerySim, an open-source extension for the 3D Slicer platform that enables interactive virtual registration, evaluation, and comparison of multiple preformed orbital plates in a patient-specific virtual planning environment. The software generates reproducible quantitative plate-to-orbit distance metrics and visualization tools that support both patient-specific planning and population-level statistical analysis of plate adaptability. By facilitating objective comparison of implant designs and placement strategies, this tool aims to improve preoperative decision-making, reduce intraoperative plate modification, and promote collaborative research and surgical education. Pilot studies, sample datasets, and detailed tutorials are provided to support testing, transparency, and reproducibility.