A randomised controlled study of the efficacy of hypromellose and Lacri-Lube combination versus polyethylene/Cling wrap to prevent corneal epithelial breakdown in the semiconscious intensive care patient.
OBJECTIVE
To compare the efficacy of two forms of eye care (hypromellose and Lacri-Lube combination vs polyethylene/Cling wrap covers) for intensive care patients.


METHODS
Randomised-controlled trial.


METHODS
University affiliated, tertiary referral hospital.


METHODS
One hundred ten patients with a reduced or absent blink reflex were followed through until they regained consciousness, were discharged from the facility during study enrolment, died or developed a positive corneal ulcer or eye infection.


METHODS
All patients received standard eye cleansing every 2 h. In addition to this, group one ( n=60) received a treatment combining hypromellose drops and Lacri-Lube (HL) to each eye every 2 h. Group two ( n=50) had polyethylene covers only placed over the eye to create a moisture chamber.


RESULTS
Corneal ulceration was determined using corneal fluorescein stains and mobile slit lamp evaluation, performed daily. No patients had corneal ulceration in the polyethylene cover group, but 4 patients had corneal ulceration in the HL group.


CONCLUSIONS
Polyethylene covers are as effective as HL in reducing the incidence of corneal damage in intensive care patients.
Koroloff
Natasha
N
Department of Intensive Care Medicine, Royal Brisbane Hospital, Level 3 Ned Hanlon Building, 4029 Herston, Queensland, Australia.
Boots
Robert
R
Lipman
Jeff
J
Thomas
Peter
P
Rickard
Claire
C
Coyer
Fiona
F
D001315:Australia / Q000453:epidemiology; D001458:Bandages; D002724:Chlorobutanol / Q000627:therapeutic use; D003244:Consciousness Disorders / Q000150:complications / Q000451:nursing*; D003320:Corneal Ulcer / Q000453:epidemiology / Q000209:etiology / Q000517:prevention & control*; D004338:Drug Combinations; D005260:Female; D006801:Humans; D065347:Hypromellose Derivatives; D007362:Intensive Care Units; D007809:Lanolin / Q000627:therapeutic use; D008297:Male; D008747:Methylcellulose / Q000031:analogs & derivatives / Q000627:therapeutic use; D008875:Middle Aged; D008899:Mineral Oil / Q000627:therapeutic use; D009883:Ophthalmic Solutions / Q000627:therapeutic use*; D010577:Petrolatum / Q000627:therapeutic use; D020959:Polyethylene; D018709:Statistics, Nonparametric
D004338:Drug Combinations; D009883:Ophthalmic Solutions; D065347:Hypromellose Derivatives; C014633:lacri-lube; D007809:Lanolin; D010577:Petrolatum; D008899:Mineral Oil; D020959:Polyethylene; D008747:Methylcellulose; D002724:Chlorobutanol