Eye protection chamber versus adhesive tape to prevent corneal injury in critically ill patients: A randomized pilot-controlled trial

To evaluate the efficacy and feasibility of the eye protection chamber compared to adhesive tape in preventing corneal injury in critically ill adult patients.

A two-arm, double-blind pilot randomized controlled trial following CONSORT guidelines. 80 critically ill patients were randomized into an intervention group (n = 40; eye drops plus eye protection chamber) and a control group (n = 40; eye drops plus micropore adhesive tape). Corneal health was assessed by a trained critical care nurse on days 1, 3, 5, 7, and 10 using fluorescein staining and portable slit-lamp examination. The primary outcome was the incidence of corneal injury. Secondary outcomes included the severity and associated risk factors.

During the study period, 203 patients were assessed for eligibility. Of these, 123 (60.6 %) presented with corneal injury upon admission and were excluded, while 80 patients (39.4 %) met the inclusion criteria and were enrolled in the trial. In a randomized trial, corneal injury occurred in 11.2 % of participants, 7.5 % in the control group, and 3.75 % in the intervention group, indicating a 50 % reduction in risk with the chamber. Most injuries were classified as Grade 1. Grade 2 and bilateral injuries occurred only in the control group.

The eye protection chamber was effective and viable in reducing the incidence and severity of corneal injuries compared to adhesive tape.

The chamber demonstrated efficacy and feasibility in preventing corneal injuries in critically ill patients with impaired or absent blink reflexes, and it can be tested in other centers. Implementing preventive strategies, such as eyelid closure, lubrication, and mechanical protection, is essential to enhance patient safety and reduce avoidable ocular complications in intensive care settings.