Choice of treatment strategy for patients with orbital foreign bodies in modern combat trauma

According to the Volkov chair of ophthalmology, the incidence of eye injuries during modern armed conflicts (MACs) is 12.3–20.4 %. In addition to damage to the eye and adnexal structures, eye injuries also include orbital combat trauma (OCT), which accounts for 20–37 % of eye injuries. During MACs, the incidence of combat trauma (CT) with orbital foreign bodies (OFB) was 47.9 % of all OFBs. OFBs in MACs may be accompanied by pain, oculomotor disorders, and infectious complications that threaten not only vision but also the patient’s life.

The purpose of the study was to determine the indications and contraindications for FB removal in orbital MACs.

Material and methods. The prospective study included 69 patients treated for OFBs in MACs at the clinics of the Kirov Military Medical Academy.

Results. An absolute indication for FB removal is the presence of a purulent-inflammatory process in the orbit. Relative indications for FB removal include their medium (1–1.5 cm) and large (> 1.5 cm) size, location in the anterior third of the orbit and independent palpation by the patient, diplopia, and impaired position and mobility of the eyeball or its musculoskeletal stump. Contraindications to FB removal include surgical interventions involving opening of the fibrous capsule of the eyeball and/or for open eye trauma within the previous 30 days.

Conclusion. The choice of treatment strategy is substantiated, and indications and contraindications for FB removal in BT are defined, allowing for increased treatment effectiveness.

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