Abstract
Purpose. To determine the clinical and X-ray features of combat orbital trauma with post-traumatic loss of the eye. Particularly, special consideration was given to the type and location of injuries of the bones of the orbit and adjacent structures, change in the bony orbital volume, and status of periorbital soft-tissue structures.
Material and Methods. We retrospectively reviewed medical records of 52 patients (69 affected orbits) aged 22 to 69 years who underwent treatment for orbital wounds at the Department of Maxillofacial Surgery, Bogomolets National Medical University, in 2022-2026. A commercial software package [Mimics Innovation Suite (Materialise NV, Leuven, Belgium)] was used to develop models of the affected and unaffected orbits and calculate the volumes of these orbits. Orbital fractures were classified into five categories according to Jaquiéry.
Results. Orbital fractures of Jaquiéry categories IV and V were most common among study patients. The mean volume of the traumatized orbit was 33.57 cm3 [median, 32.1 cm3; interquartile range, 29.5-36.4 cm3]. Of the 69 affected orbits, 36 (52.2%) had isolated orbital wall defects. Of the 52 patients, 16 (30.8%) had isolated lower-lid defects, and 26 (50.0%) had combined eyelid deformities, which constituted the majority of periorbital soft-tissue injuries. The eye was removed by evisceration in 38 (73.1%) of the 52 patients. The inferior orbital margin was the most common site of orbital bony defects (n = 19; 27.5%).
Conclusion: Combat wounds of the orbit vary widely in the nature and extent of the traumatic process, from isolated orbital wall fractures and eyelid defects and deformities, to massive complex wounds with multifragmented fractures, defects in bony structures and soft tissues, and extensive soft-tissue damage and cicatrization. The bony orbital volume of the affected orbits tended to change depending on the involvement of adjacent structures and the type of the fracture.