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Moisture chamber versus lubrication for the prevention of corneal epithelial breakdown
D Cortese1, L Capp, S McKinley
1Royal Melbourne Hospital, Victoria, Australia.
Background:
Patients who are comatose or semicomatose are at risk of corneal dryness and ulceration.
Objective:
To compare and evaluate the effectiveness of two treatments used for the prevention of corneal epithelial breakdown in critically ill patients.
Methods:
A randomized clinical trial was used. The sample consisted of critically ill patients (age, 15-84 years) with a limited or absent blink reflex in a 14-bed general intensive care unit in a large metropolitan teaching hospital. Ninety-six eligible patients were studied; of these, 36 were excluded and data from the remaining 60 patients were analyzed. Patients were randomized to receive methylcellulose lubricating drops every 2 hours (n = 30) or to have their eyes covered with a polyethylene film to create a moisture chamber (n = 30). The patients' corneas were tested daily for epithelial breakdown using fluorescein drops. Patients were studied for a minimum of 48 hours and a maximum of 1 week.
Results:
Eight of the 30 patients in the lubricating drop group had positive fluorescein staining, compared with one in the moisture chamber group.
Conclusion:
Our results suggest that a moisture chamber is more effective than lubricating drops in preventing corneal epithelial breakdown in critically ill patients with limited or absent blink reflex.