Retrospective comparative analysis of ophthalmic injury patterns, surgical management, and medical rehabilitation of military personnel across different regions

Abstract

In the context of intensive hostilities, early diagnosis of ophthalmic injuries, well-defined patient routing, and a multidisciplinary approach to treatment are of critical importance. Most injuries are caused by blast, shrapnel, and fragment mechanisms, resulting in high-energy penetrating wounds, extensive destruction of ocular anatomical structures, and combined craniofacial trauma. The purpose of this study was to perform a retrospective comparative analysis of international and national scientific evidence and to analyze the structure of ophthalmic injuries and the specific features of surgical management among military person¬nel in different regions of Ukraine. The study sought to identify regional variations in the patterns and severity of ocular trauma, the extent and tactical approaches of surgical interventions, and to evaluate the influence of injury mechanisms, timeliness of specialized ophthalmic care, and organizational aspects of patient routing on clinical outcomes. Materials and methods. The study employed content analysis of national and interna¬tional scientific sources, as well as systematic literature review, analytical, and statistical research methods. The analysis was based on data from 78 military personnel who received treatment in two regions of Ukraine. Results. Prevalence and nature of ocular injuries: in both cohorts, the most frequently recorded injuries were penetrating globe injuries with intraocular foreign bodies (17.1 % in Haisyn and 33.3 % in Cherkasy) and traumatic cataracts (11.4 % and 11.1 %, respectively), indicating the significant role of mechanical, including penetrating, trauma in the development of severe ophthalmic complications. The incidence of burns and open wounds was lower: in Haisyn, both accounted for 8.6 %, whereas in Cherkasy, open wounds were detected in 29.6 % of patients and burns were absent. Ocular contusions were less common, occurring in 2.9 % of cases in Haisyn and 22.2 % in Cherkasy. Regional differences: in the second cohort (Cherkasy), the proportion of ocular injuries with intraocular foreign bodies (33.3 vs. 17.1 % in Haisyn) and open wounds (29.6 vs. 8.6 %) was significantly higher, indicating a more severe injury profile and a greater prevalence of penetrating trauma. The frequency of ocular contusions (22.2 %) and the decreased incidence of purulent endophthalmitis (7.4 vs. 14.3 % in Haisyn) reflect different trauma mechanisms and variations in the course of complications. Prevalence of surgical interventions: in the first sample (Haisyn), the most frequently performed procedures were “other surgical interventions” - 40.0 %, foreign body removal – 20.0 %, evisceration and surgical wound management – 14.3 % each, lens extraction with implantation - 11.4 %. In the second sample (Cherkasy), surgical wound management predominated – 46.9 %, intraocular foreign body removal was performed in 21.9 % of cases, lens extraction – in 9.4 %, evisceration – in 6.25 %, and other interventions – in 15.5 %. Conclusions. Timely integration of early surgical intervention, coordination of a multidisciplinary team, and implementation of modern rehabilitation approaches significantly improve anatomical and functional outcomes, reduce the risk of vision and eye loss, and promote more effective social and professional reintegration of affected military personnel.