title: Corneal protection during general anesthesia for nonocular surgery.
abstract: Corneal abrasion is the most common ophthalmologic complication that occurs during general anesthesia for nonocular surgery. Such abrasions can be caused by a variety of mechanisms and can lead to sight-threatening microbial keratitis and permanent scarring. There is no standard mode of protecting the cornea during general anesthesia for nonocular surgery. Methods described in the literature are not entirely effective and may be associated with unwanted side effects. Taping alone provides protection that is equivalent or superior to other interventions and has fewer side effects. Petroleum gel is flammable and is best avoided when electrocautery and open oxygen are to be used around the face. Preservative-free eye ointment is preferred, as preservative can cause corneal epithelial sloughing and conjunctival hyperemia. Recently, the application of Geliperm and bio-occlusive dressings has been advocated. Geliperm may be particularly useful during endonasal surgery when continuous perioperative observation of the eye is required. In this article, the literature on the etiology of perioperative corneal abrasions is reviewed and various protection strategies are compared in order to identify the best methods to prevent corneal abrasions during general anesthesia.
authors.affiliation: Department of Ophthalmology, Royal Liverpool University Hospital, Liverpool, UK. grixti.andre@gmail.com
authors.forename: Andre
authors.initials: A
authors.lastname: Grixti
authors.forename: Maziar
authors.initials: M
authors.lastname: Sadri
authors.forename: Mark T
authors.initials: MT
authors.lastname: Watts
mesh_terms: D000768:Anesthesia, General / Q000009:adverse effects*; D065306:Corneal Injuries; D005131:Eye Injuries / Q000209:etiology / Q000517:prevention & control*; D006801:Humans; D013508:Ophthalmologic Surgical Procedures / Q000379:methods*; D059035:Perioperative Period