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

Intensive Care Med. 2004 Jun;30(6):1122-6. doi: 10.1007/s00134-004-2203-y. Epub 2004 Mar 10.

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.

Publication types

  • Clinical Trial
  • Comparative Study
  • Randomized Controlled Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Australia / epidemiology
  • Bandages*
  • Chlorobutanol / therapeutic use
  • Consciousness Disorders / complications
  • Consciousness Disorders / nursing*
  • Corneal Ulcer / epidemiology
  • Corneal Ulcer / etiology
  • Corneal Ulcer / prevention & control*
  • Drug Combinations
  • Female
  • Humans
  • Hypromellose Derivatives
  • Intensive Care Units
  • Lanolin / therapeutic use
  • Male
  • Methylcellulose / analogs & derivatives
  • Methylcellulose / therapeutic use
  • Middle Aged
  • Mineral Oil / therapeutic use
  • Ophthalmic Solutions / therapeutic use*
  • Petrolatum / therapeutic use
  • Polyethylene
  • Statistics, Nonparametric

Substances

  • Drug Combinations
  • Ophthalmic Solutions
  • Hypromellose Derivatives
  • lacri-lube
  • Lanolin
  • Petrolatum
  • Mineral Oil
  • Polyethylene
  • Methylcellulose
  • Chlorobutanol