Volume 30, Number 6, 1122-1126, DOI: 10.1007/s00134-004-2203-y

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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

Natasha Koroloff, Robert Boots, Jeff Lipman, Peter Thomas, Claire Rickard and Fiona Coyer

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Abstract

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.

Design  

Randomised-controlled trial.

Setting  

University affiliated, tertiary referral hospital.

Patients and participants  

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.

Interventions  

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.

Measurements and 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.

Keywords  Clinical nursing research - Critical care - Eye - Epithelium - Corneal

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