Anatomical results of penetrating keratoplasty as an element of combined opto-reconstructive surgery in the treatment of combat eye injury

Purpose. To evaluate the results of penetrating keratoplasty (PK) as an element of opto-reconstructive surgery (ORS) for combat injury to the eye. Material and method. The study included 43 eyes of 39 male patients aged 22 to 59 years. The patients were divided into two groups: the main group — OGI with damage to the structures of the anterior and posterior segments — 34 patients (37 eyes), and the control group — inflammatory diseases of the anterior segment that complicated severe combat injury to the eye with an intact posterior segment — 5 patients (6 eyes). All patients underwent PK, in addition to which there could be: installation of a temporary keratoprosthesis, reconstruction of the anterior chamber, removal of traumatic cataract, hemvitrmembranectomy, removal of IOFB, straightening of the retina with perfluoroorganic compounds, retinotomy, carrying out delimiting threads, filling the vitreal cavity with silicone oil, drainage of hemorrhagic detachments of the vascular membrane. The degree of transparency of the graft was assessed at the postoperative stage. The follow-up period in the main group was 59 ± 29 days, in the control group — 82 ± 34 days. Results: in the main group, transparent graft engraftment was observed in 62.16 % of cases, semi-transparent in 35.14 %, opaque in 2.7 %. In the control group, transparent graft engraftment was observed in 83.33 %, and opaque in 16.67 %. The duration of graft epithelialization in the main group was 8.05 ± 3.86 days, in the control group — 25.24 ± 11.87 days. Conclusion. The anatomical result of PK as an element of complex reconstructive surgery of combat eye injury depends primarily on the nature of the pathology of the eyeball. The presence of inflammatory processes with the preservation of underlying ocular structures is characterized by a better functional prognosis than an open injury. Keywords: open globe injury, penetrating keratoplasty, keratograft engraftment