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Prehospital services for ocular burns are delivered by servicemen as self or mutual management and also by paramedic. Every case of ocular burn should be considered as severe one. The patient, shortly after the first aid, should be transported to the medical company or medical unit. Under conditions of medical unit military doctor has to organize an ophthalmological working space (ophthalmological comer) with the necessary equipment. Eye irrigation has to be made for chemical ocular burns. Military doctor should consider any previous irrigation as insufficient. For severe ocular burns during evacuation to the hospital it is necessary to perform a simple blepharorrhaphy or (if the condition of lids allows) to make a hermetic seal with aid of aid-band. Doctor's obligations should also include prophylaxis of ocular burns.

Clinical patterns of ocular burn in patients with different types and variants of stress reactivity were studied. It is shown that patients with the maladaptive type of stress reactivity at any stage of the disease are at higher risk of complications. Rapid exhaustion of the sympathoadrenal system or a hyperactive stress response seen in cases of the labile and hyperergic individual adrenergic immune reactivity of the organism (IAIRO) can be considered as manifestations of a regulation disorder. The absence of complications along with mild changes in immune reactivity is characteristic of the normoergic variant of IAIRO.

Early defects due to the afflux of monocytic phagocytes into the inflammatory focus, rapid resorption of detritis and normalisation of correlation between contents of matrix proteinases and their inhibitors, stimulation of stromal cornea keratinocytes migration and their proliferation characterize repair of postburn defects in transplantation of the stromal equivalent. Repair against the background of stromal equivalent transplantation is of a histotypical character: collagen gel organizes and serves the basis for migration of the cornea fibroblasts and temporary matrix for growing new epithelium, while restored basal membrane is a derivative of cornea epithelium.

We propose to treat deep corneal burns by grafting a living stromal equivalent, since keratocyte death and stromal destruction are the main factors of ulceration and destruction of the eye. A technique was developed for isolation and grafting a living stromal equivalent. Twenty one patients with deep corneal defects were treated. A stable therapeutic effect was observed in 95% of cases. The advantage of the developed method is partial recovery of affected corneal transparency.

Comprehensive recent research of eye traumatism is described, aspects related with changes in the trauma structure are defined and advanced methods of diagnostics as well as of therapeutic and surgical treatment in eye trauma are elucidated in the paper. It is pointed out that the above study results are valuable for rehabilitation of victims during peacetime, in emergency situations and in calamities; the contribution of civil ophthalmologic institutions to rendering a specialized medical care to victims of military conflicts is equally important. The case study comprises extensive research findings that can be used in the below cases requiring a specialized medical care: penetrating eye injuries, contusion, burn injuries of the eye, splintered trauma etc.; the current micro-surgery standards must be adhered to and the latest technologies must be used. Finally, the important role of and valuable contributions to the above research made by the Calamity Medicine Center ("Zashchita") are underlined.

Proteinase-inhibitor balance in the lacrimal fluid in eye burns was studied in rabbits with modified and intact immune status. Stimulation of the immune system was induced by complete Freund's adjuvant. Clinical picture of the disease was studied in parallel. Immunization accelerated the local adaptive and defense reaction of the proteolytic enzymes and their inhibitors, which was paralleled by a more benign course of burn disease of the eyes, in comparison with that in non-immunized animals.

Necrolytic properties of lecozyme diluted with urea were studied on a model of isolated alkaline burn of the cornea with 10% NaOH applied for 10 sec. Experimental studies were carried out on both eyes of 62 rabbits (124 eyes). Lecozyme applications in a dose of 17.5 FIP dissolved in urea in concentrations of 3.5 to 40% brought about a complete necrolytic effect in all cases. The results of keratoplasty depended on the concentration of urea. High concentrations (10-40%) caused severe complications in the eye (endophthalmitis). Application of 5-10% urea solutions caused no complications, but the graft healing was opaque in all cases. Satisfactory results were attained with 3.5 and 4% urea. Postoperative course and outcomes of keratoplasty after pretreatment with lecozyme were better than in the control animals subjected to surgical necrectomy. We explain better results of surgical treatment of induced burns by a higher quality of necrectomy, which can be attained by the enzyme. No melting or perforation of the cornea due to the enzyme was observed in any case. Good results of experiments necessitate further experimental and clinical studies.

Kerakol efficacy in experimental burn and mechanical injuries was studied. The drug was shown to stimulate repair processes in the cornea, promoting an earlier differentiation of epithelial cells and their layers. Corneal stroma repair manifested by an earlier maturation of collagen structures with their correct orientation. Clinical trials showed kerakol efficacy in the treatment of corneal burns and injuries.

The character and results of eye burn treatment have been studied in 226 patients (307 eyes) aged from 10 to 80 years. The analysis of the character of eye burns has shown that the overwhelming majority of them were chemical ones (80.54%), of them 50% being alkaline. As to degree of severity, burns of moderate degree predominated (58.74%). The greatest part of the sufferers had everyday-life burns (67.7%). Results of treatment depended, mainly, on the severity of the burn. By the results of treatment, the patients were divided into 4 groups: group I included patients with total restoration of corneal transparency, who can return to their former labor activity; group-II patients with partially lost visual functions on account of remained, moderately expressed cicatricial opacifications of the cornea, who in future require repeated courses of resolving therapy; group-III patients with a remarkable loss of visual functions on account of coarse cicatricial opacifications of the cornea, who in future require surgical treatment--keratoplasty, keratoprosthesing and other surgical interventions; group IV-patients with total restoration of corneal transparency after treatment, but with insufficiently high visual acuity because of associated changes in the optic media and the eye fundus (beginning cataract, macular dystrophy, etc.), who require dispensary observation and treatment of associated diseases.

Comparative assessment of results after treatment of 90 patients with chemical burns of moderate and severe degrees was made using a sorption (103 eyes) and traditional (47 eyes) methods of treatment. The sorption method included the usage of ocular medicinal ionometabolic insertions and a 10% medicinal gelatine that are able to eliminate ions from the burning substance and toxic product formed in the eye due to burns. As a result of treatment, the sorption method allowed to obtain higher functional results, to achieve a shorter time for the patient's stay in the hospital, by 11.2 bed-days, on the average. Thanks to the sorption method introduced into the clinical practice the economic effect made up about 50,000 rubles yearly.

The paper analyses results of clinico-immunologic examinations of patients with severe eye burns. Immunologic investigations were made on a laser cytofluorometer "SPECTRUM II" (USA) using monoclonal antibodies OCT-3, OCT-4, OCT-8, OCT-11. Correlation between changes of the level of T-lymphocytes subpopulation and the severity and outcome of the trauma was established and prognostic significance of immunoregulatory index OCT-4/OCT-8 proved. The necessity of selective aimed immunocorrection is substantiated.

In 14 patients (22 eyes) with a burn disease of the eye, a "dry eyes" syndrome was diagnosed. Its diagnostic signs were simultaneous reduction of physiologic tear production to 7 mm and the shortening of time of the tear film break to 8 sec. and lower. The mentioned values were indications to instillations of a preparation, a so-called "artificial tears" (a 6% water solution of polyvinylpyrolidone). Such a therapy allowed to increase the volume of fluid in the conjunctival sac and the stability of tear film as well as in 87.5% of patients to remarkably reduce subjective disorders.

Experiments on 68 rabbits with degree III burn induced by potassium bichromate were made to study and compare the therapeutic effect of subconjunctival injections of autoplasma with heparin and penicillin and instillations of spermaceti oil. Administration of spermaceti oil for the treatment of burns provides a more remarkable clinical effect, contributing to a milder course of burn process.