Effect of polyethylene cover on the treatment of exposure keratopathy in ICU.

Abstract

Exposure keratopathy may lead to serious complications such as microbial keratitis, corneal perforation, and visual impairment if not treated. To compare the effect of carbomer eye drops when used alone and in combination with polyethylene covers in the healing of exposure keratopathy. A single blind randomized-controlled trial (RCT) in two intensive care units (ICUs) was carried out in a university hospital in Western Turkey between September 2011 and December 2012. The control group received only carbomer, eye drops while the intervention group received both carbomer eye drops and polyethylene covers. The primary outcome was the decrease or absence of corneal damage, which refers to healing. Corneal damage was followed up with a fluorescein dye test (decrease/absence of the corneal staining) by the same ophthalmologist for 10 days. A total of 43 corneas in 24 patients were studied. Corneal epithelial defects decreased in the intervention group by day 2 and progressed or remained unchanged in the control group every day (P= .001). Patient characteristics did not affect the grade ranges of corneal staining in the groups except for level of consciousness. Carbomer eye drops, when used in combination with polyethylene covers, were effective in managing exposure keratopathy. Corneal damage and further ocular complications can be reduced with the utilization of polyethylene covers in nursing care and treatment.