Abstract

Background. The armed aggression of the Russian Federation against Ukraine in 2022 led to a sharp increase in the number of severe injuries among both civilians and military personnel, including injuries to the organ of vision. Particular attention should be paid to the growing relevance of the problem of anophthalmic syndrome in Ukraine, which in recent years has increased significantly due to the rise in the number of severe ocular injuries, especially mine-explosive and gunshot wounds. According to contemporary studies, combat-related eye injuries are characterized by a high incidence of loss of the eyeball and the development of persistent cosmetic and psychoemotional disorders, necessitating comprehensive reconstructive and psychological rehabilitation.
Aim: to evaluate the clinical, cosmetic, and psychoemotional effectiveness of orbital soft tissue reconstruction using an intraorbital implant in patients with anophthalmic syndrome.
Materials and Methods. A prospective clinical study with dynamic follow-up was conducted involving 42 patients with unilateral anophthalmic syndrome after enucleation. All patients underwent orbital soft tissue reconstruction with implantation of an intraorbital implant. Morphometric parameters of the orbit were assessed using computed tomography. Cosmetic satisfaction was evaluated using the visual analog scale, and psychoemotional status was assessed using the hospital anxiety and depression scale. Examinations were performed before surgery and at 3, 6, and 12 months after the intervention.
Results. Before surgery, all patients demonstrated clinically significant orbital asymmetry, with a mean affected orbital volume of 19.1 ± 3.0 cm³, which was 25-30% lower compared to the contralateral side, and reduced soft tissue thickness of 4.4 ± 0.8 mm. Cosmetic satisfaction was low and accompanied by mild to moderate psychoemotional distress. Three months after reconstruction, orbital volume increased to 21.0 ± 2.8 cm³, soft tissue thickness to 5.0 ± 0.7 mm, and cosmetic satisfaction to 6.1 ± 1.2 points. At 6 months, orbital volume reached 21.6 ± 2.6 cm³ and soft tissue thickness 5.4 ± 0.5 mm, while at 12 months orbital volume increased to 21.8 ± 2.5 cm³, corresponding to 90-93% of the contralateral side. Cosmetic satisfaction increased to 8.0 ± 1.0 points, and anxiety and depression levels decreased by more than half compared to baseline values. Postoperative complications were predominantly mild and transient.
Conclusion. Orbital soft tissue reconstruction using an intraorbital implant provides sustained improvement in morphometric, cosmetic, and psychoemotional parameters and represents an effective method of comprehensive rehabilitation for patients with anophthalmic syndrome