Effectiveness of Comprehensive Detoxification Therapy in Ophthalmological Complications in Critically Ill Comatose Patients

Objective. To evaluate clinical and laboratory parameters in patients with ophthalmological complications of varying severity during standard therapy and comprehensive treatment including infusion detoxification therapy. Materials and Methods. A prospective comparative study was conducted in critically ill comatose patients admitted to the intensive care unit. Patients with bacterial conjunctivitis, superficial keratitis, and corneal xerosis were randomized into a main group and a control group. The main group received standard local ophthalmological therapy combined with systemic infusion detoxification therapy, while the control group received only conventional topical treatment. Clinical assessment was performed using the Maychuk inflammatory grading scale. Laboratory monitoring included leukocytic intoxication index (LII), hematological intoxication index (HII), and medium molecular peptides (MMP). Examinations were performed before treatment and on days 3, 5, and 7 of therapy. Statistical significance was accepted at p<0.05. Results. Patients receiving comprehensive therapy demonstrated significantly faster regression of inflammatory manifestations compared with the control group. In bacterial conjunctivitis, the Maychuk score decreased from 10.2±0.3 to 2.2±0.2 by day 7 in the main group, whereas in the control group it remained at 4.7±0.3 (p=0.0003). Similar positive dynamics were observed in patients with superficial keratitis and corneal xerosis. Significant improvement was also observed in laboratory intoxication markers. By day 7, LII decreased to 1.12±0.08 in the main group compared with 1.87±0.09 in controls (p<0.001). HII and MMP values demonstrated comparable reductions, indicating decreased systemic inflammatory burden and endogenous intoxication. Conclusion. Comprehensive therapy including infusion detoxification treatment demonstrated significantly greater clinical and laboratory effectiveness than standard local therapy alone in critically ill patients with ophthalmological complications. Correction of systemic intoxication contributed to faster resolution of ocular inflammation, improvement of ocular surface condition, and reduction of inflammatory-intoxication syndrome.

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