Author’s Disclosure Block: Vladimir Kratky, none

Abstract Body
Purpose: Eye trauma is estimated to account for 20 per cent of all injuries in modern warfare. Due to widespread bombing and shelling in Ukraine, there are many patients with extensive facial injuries, including loss of eyes, and eyelid and orbital deformities, with complexity and extent not seen in peace-time accidents. This is a summary overview of a recent mission to Ukraine by the charitable Face-the-Future Foundation, with a multispecialty facial surgical team, including an oculoplastic surgeon. Study Design: An observational case series review, demonstrating facial injuries as a result of explosions with shockwave and shrapnel trauma in a war-zone, and utilizing Patient Specific Implants (PSI) for orbital reconstruction. Methods: A detailed prospective documentation of all orbital cases was kept on file, including pre- and post-op photographs and imaging. In addition, the design and configuration of PSI’s was stored for each patient. Illustrative intraoperative pictures were used complement most cases. The cases were then grouped according to main diagnosis and each written up as a small case report. A compilation of these will be used to illustrate each orbital trauma category. The design and application of patient specific implants (PSI) in this population will also be described. Review of wartime facial injury literature will be discussed. Results: Six illustrative cases of orbital and midface trauma will be presented to document the different injuries which result from war-time trauma. Most common relevant surgical techniques and the design and implantation of PSI’s will also be covered. With respect to the orbital region, the most common secondary deformities included traumatic telecanthus, hypovolemic/contracted anophthalmic sockets and traumatic eyelid malpositions. In addition, lagophthalmos with severe corneal exposure was commonly found in traumatic VII nerve palsies. Conclusion: This presentation will demonstrate the type and extent of injuries to the orbital area and facial region from shockwave and shrapnel trauma, specific to war weapons of destruction. There a distinct and unique pattern of damage, which is different from injuries in the general peacetime population. In addition, Patient Specific Implants play a very important role in the reconstruction of complex skull fractures.