BACKGROUND: Eye injury is an actual problem, occupying a leading position among the main causes of blindness and low vision, accounting for 22.8% in the structure of primary visual disability, of which 53% of cases are due to closed eye injury. Despite the development and widespread introduction into practice of methods of high-tech care for patients of this profile, there are a number of complications that poorly respond to treatment, ultimately leading to the loss of visual function of the injured eye. AIM: Evaluation of the effectiveness of early vitrectomy in patients with severe blunt ocular trauma, based on clinical results obtained during treatment and postoperative follow-up. MATERIALS AND METHODS: The study included 34 patients (34 eyes) with contusion-type eye injury. The mean age of patients was 39 years, among them 30 were men (88.24%) and 4 (11.76%) women. Patients were divided into 2 groups. Group 1 included 11 patients (10 men, 1 woman) with an open-type eye injury with a subconjunctival scleral rupture; upon admission, visual acuity varied from incorrect light projection to 0.01. In group 2, there were 23 patients (20 men, 3 women) with severe closed eye injury, upon admission to the hospital, visual acuity ranged from incorrect light projection to 0.06. In all cases, patients underwent subtotal three-port vitrectomy at an early date (up to 3 days) after injury. RESULTS: On the 1st day after surgery, there was an improvement in visual acuity in all patients. The follow-up period for patients was 6 months. All included patients had a stable anatomical result, no cases of subatrophy were noted, satisfactory functional results were achieved - visual acuity varied from 0.02 to 0.8. After 6 months, 32 out of 34 eyes (94.12%) showed no signs of proliferative vitreoretinopathy. In 2 patients (18.18%) from group 1, the development of proliferative vitreoretinopathy under silicone oil was revealed. Epiretinal membrane was diagnosed in 2 patients (8.7%) from group 2 and in 1 patient (9.09%) from group 1. CONCLUSIONS: Obtained clinical results of treatment of patients with severe blunt ocular trauma indicate the expediency of vitrectomy in early stages after injury, which is an effective treatment method. Long-term results demonstrate stable functional results for 6 months. Vitrectomy performed early after injury serves for prevention of proliferative vitreoretinopathy, but does not completely exclude its development. Performing surgery early after injury increases the prospects for preserving visual functions of the eye and is a positive prognostic factor.

Purpose: to present the functional results of primary early vitrectomy in patients with subtotal and total hemophthalmos with penetrating wounds and severe contusions of the eye. Material and methods. 41 patients were observed, including 24 patients (24 eyes) with a penetrating eye injury and 17 patients (17 eyes) with a severe eye contusion. All patients had subtotal or total hemophthalmos. All patients underwent a 25G three-port vitrectomy no later than 3 days after the injury. 33 patients received a tamponade with silicone oil 5700, and 8 patients received gas-air mixture C3F8. The follow-up period was 6 months. Results. On the first day after surgery, 31 patients treated with silicone oil tamponade showed an improvement in visual acuity. With gas-air tamponade, visual acuity as light perception was obtained for 1 day; as the gas resorbed, objective vision appeared in all 8 cases. Six months after the surgery, a good anatomical result was achieved: no signs of subatrophy were detected in any of the presented patients. An unfavorable outcome (lacking or incorrect light perception) was observed in 4 cases (9.75%), a relatively favorable functional outcome in the form of objective vision less than 0.1, in 17 cases (41.5%), a favorable outcome with visual acuity above 0.15 in 20 cases (49%). Signs of proliferative vitreoretinopathy were noted in 8 patients (19.5%), which in cases of severe penetrating wounds and contusions and a number of complicating factors is a good result as compared to the available literature statistics. Conclusion. Our study shows that in patients with total and subtotal hemophthalmos with penetrating eye wounds and severe contusions, primary vitrectomy should be performed at an early stage. After the surgery the patients receive a statistically significant increase in visual acuity, have a stable anatomical result and, in the long term, obtain a good functional result.

Aim. To present a clinical case of severe open injury of the eyeball of a con-tusion nature with the presence of intraocular complications and to show that de-spite the significant severity of the injury, good results can be achieved. Material and methods. Patient injured his right eye at home with a metal tip on a rubber band, after which his vision sharply decreased, pain and lacrimation of the right eye appeared. Objectively: vision of the right eye pr. l. certae, intraocular pressure (palpation) - hypotension. No foreign body was found on the survey radi-ograph of the orbits. An ultrasound B-scan revealed hemophthalmus, and subse-quently (after 7 days) retinal detachment appeared. The patient underwent vitrec-tomy, tamponade of the vitreous cavity with silicone oil, endolaser coagulation of the retina. Results. On the 1st day after the operation, the visual acuity increased to 0.4 with correction (shp +8.0). 3 months after discharge from the hospital, the patient had complete safety of the eyeball and stable functional results were achieved, where the visual functions of the injured eye were 0.5 with correction (shp + 8.0). Conclusions. A clinical case of severe open eye injury with extensive sub-conjunctival rupture of the sclera, hemophthalmos and retinal detachment demon-strates that, despite the severity of the injury, with timely provision of high-tech surgical care, there is a real chance of saving the eyeball and get high visual func-tions. Key words: Traumatic vitreous haemorrhage; vitrectomy; subconjunctival rupture of the sclera; retinal detachment.

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