Открытая травма глаза. Предполагаемые и реальные сложности хирургии

Abstract

Purpose. To analyze two clinical cases of open eye injury after penetrating sclerocorneal injury. Material and methods. Both patients were admitted to the clinic after a penetrating sclerocorneal wound with a sharp object 2–3 hours after the injury. In both cases, primary surgical treatment and optical reconstructive surgery were performed simultaneously. On average, the duration of operations varied from 6 hours to 8 hours (total of primary surgical treatment + optical-reconstructive surgery). Results. In the first case, a complete anatomical comparison of all structures and membranes of the eye. The optimal volume of intervention was carried out, and all conditions were created for final reconstructive surgery. The rehabilitation period is 7 months. In the second case, it was possible to completely seal the eyeball, match all the ocular structures that were damaged during the injury, and achieve anatomical correspondence. Carefully performed simultaneous primary surgical treatment and optical reconstructive surgery allowed us to effectively complete silicone tamponade after 4 months, as well as lamellar keratoplasty after 7 months. The rehabilitation period is 14 months. Conclusion. An individual approach to each open eye injury with one-stage primary surgical treatment and optical-reconstructive surgery makes it possible to stabilize the pathological processes that are triggered during the injury, achieve maximum comparison of the anatomical structures and membranes of the eye, eliminate the consequences of injury with minimal surgical complications, and create favorable conditions for subsequent (if necessary) reconstructive stages, to obtain maximum functional results.