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
- 674 Downloads
To compare the efficacy of two forms of eye care (hypromellose and Lacri-Lube combination vs polyethylene/Cling wrap covers) for intensive care patients.
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.
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.
Polyethylene covers are as effective as HL in reducing the incidence of corneal damage in intensive care patients.
KeywordsClinical nursing research Critical care Eye Epithelium Corneal
This study was supported by the Queensland Nursing Council’s Research Grant. The views expressed do not necessarily represent the views of the Council or the members, executive officer or staff of the Council. We thank the Medical and Nursing staff of the Royal Brisbane Hospital, Department of Intensive Care Medicine.
- 7.Fleiss J (1981) Statistical methods for rates and proportions. John Wiley, New YorkGoogle Scholar
- 10.Boyd-Monk H, Steinmetz III C (1987) Nursing care of the eye. Appleton and Lange, Norwalk, ConnecticutGoogle Scholar
- 11.Sullivan J, Brooks-Crawford J, Whitcher J (1999) Lids, lacrimal apparatus and tears. In: Vaughan D, Asbury T, Riordan-Eva P (ed) General ophthalmology. Appleton and Lange, Stamford, Connecticut, pp 74–91Google Scholar
- 12.Gilbard J (2000) Dry-eye disorders. In: Albert D, Jakobiec F (ed) Principles and practice of ophthalmology. WB Saunders, Philadelphia, pp 982–1001Google Scholar
- 13.Newell F (1996) Ophthalmology: principles and concepts. Mosby, St. LouisGoogle Scholar
- 15.Kirwan JF, Potamitis T, el-Kasaby H, Hope-Ross MW, Sutton GA (1997) Microbial keratitis in intensive care. Br Med J 314:433–434Google Scholar
- 17.Lloyd F (1990) Making sense of eye care for ventilated or unconscious patients. Nurs Times 86:36–37Google Scholar
- 24.Ellis P, Fraunfelder F (1999) Ophthalamic therapeutics. In: Vaughan D, Asbury T, Riordan-Eva P (ed) General ophthalmology. Appleton and Lange, Stamford, Conneticut, pp 57–73Google Scholar
- 25.Jaanus S (1984) Lubricant preparations. In: Bartlett J, Jaanus S (ed) Clinical ocular pharmacology. Butterworth, London, pp 287–297Google Scholar