Search

To treat patients with eye injuries remains a topical problem due to the high incidence of this type of pathology and the severity of clinical outcomes. Ciliochoroidal detachment (CCD) occurring in 1-9% of the victims is one of the most common complications of mechanical eye injury. The purpose of the study was to evaluate the efficiency of pathogenetically substantiated technology for a combined laser surgical reparative intervention in posttraumatic traction CCD. The results of treatment were analyzed in 70 patients with posttraumatic traction detachment of the choroid and ciliary body. There was evidence for the need for vitrectomy and lensectomy in combination with posterior sclerectomy to eliminate traction posttraumatic CCD.

Comprehensive (optic, electron, and fluorescent microscopy) morphological analysis of vitreous fragments removed in vitrectomy after penetrating wounds of the eye complicated by hemophthalmia showed that blood and damaged cells of pigment-free ciliary epithelium and the glia play an important role in the development of proliferative processes in the ophthalmic cavity. Immunohistochemical studies revealed active expression of immunoglobulins A and G and of HLA-DR antigen on immunocompetent cells and abnormal expression of HLA-DR in pigment-free ciliary epithelium and the glia, confirming the autoimmune origin of inflammatory disorders.

Penetrating wounds of the corneoscleral area are remarkable for particularly severe course of posttraumatic period, this being explained by direct injury to the ciliary body, impaired anatomic relationships in the anterior chamber corner, formation of this corner recession, this resulting in detachment of the ciliary body and development of the hypotonic syndrome. The authors suggest a new surgical technique of reconstructing the anterior chamber corner in its recession and detachment of the ciliary body with the aim of correcting the hypotension and fortifying the ciliary body at the site of its anatomic localization. This method was used in the treatment of 32 patients with subatrophy, detachment of the ciliary body, and hypotension; positive effect was achieved in 28.