Experience in using optical coherence tomography for monitoring of the anterior segment structures following staged surgical treatment of combat-related eye injuries

Relevance: Combat-related eye injuries often pose significant diagnostic challenges, particularly when corneal opacities hinder traditional assessment methods like biomicroscopy. Optical coherence tomography (OCT) enables high-resolution imaging of anterior segment structures, providing critical insights for accurate diagnosis and post-surgical monitoring in such cases. Objective: To evaluate the effectiveness of anterior segment OCT in monitoring structural changes in the anterior chamber following staged surgical interventions in patients with combat-related eye injuries. Materials and Methods: This prospective study included 27 patients (27 eyes) who sustained combat-related eye injuries during military operations from May to July 2023. All patients underwent vitrectomy, removal of intraocular foreign bodies, and tamponade with perfluorocarbon liquids (PFCL). Some patients also required cataract extraction and intraocular lens implantation. Anterior segment conditions were assessed pre- and postoperatively using biomicroscopy and OCT, with quantitative image analysis performed using ImageJ software. Results: OCT detected cellular inclusions in the anterior chamber in all cases (100%, p<0.001), whereas biomicroscopy identified these changes in only 33.3% of patients. Additionally, OCT revealed fibrin strands in 3.7% of cases, which were undetectable via biomicroscopy due to corneal opacity. OCT allowed for dynamic monitoring of structural changes within the anterior segment, particularly in cases involving PFCL tamponade, which affected particle distribution and concentration. Conclusion: Anterior segment OCT is a highly effective tool for the detailed visualization and dynamic monitoring of intraocular structures following combat-related eye injuries. It surpasses traditional biomicroscopy, particularly in situations where corneal transparency is compromised, and should be considered essential for postoperative care in such patients. Keywords: optical coherence tomography (OCT), combat eye injuries, inflammation, anterior chamber