Effectiveness of polyethylene covers versus carbomer drops (Viscotears®) to prevent dry eye syndrome in the critically ill

Abstract

The purpose of this study was to compare the effectiveness of the polyethylene covers versus carbomer eye drops to prevent dry eye syndrome in intensive care unit patients. Concerns about eye care for critically ill patients remain an issue. Few studies have focused on the effect of polyethylene covers and eye drops. In addition, there are no studies comparing polyethylene covers and carbomer eye drops for critically ill patients. A prospective, randomised and contralateral eye study was conducted. The study took place in an intensive care unit in 2007. Thirty-six eyes of 18 patients, who were under mechanical ventilation or unconscious for more than 24 hours in the intensive care unit, were studied. After examining the eyes of the patients with the Schirmer 1 test and fluorescein dye test, suitable patients were included in the study. One eye of the patient was randomly covered with a polyethylene cover every 12 hours, and carbomer drops were instilled on the other eye every six hours. All eyes were checked for an ocular surface abnormality by the same ophthalmologist everyday. The study interventions were continued until a defect was detected or for five days. Patients with a defect detected completed the study and were recorded as positive for the primary endpoint. Results. Carbomer drop was effective in prophylaxis of dry eye syndrome in only three of 18 patients, whereas polyethylene cover showed greater effect in 18 of 18 eyes at the end of the study (SD 0·3835, Z = -3·873, p < 0·001). A negative effect of greater rima palpebra in the resting position was observed in the efficacy of carbomer drop (r = -0·476, p < 0·05). This study suggests that a polyethylene cover is significantly effective in prevention of dry eye syndrome in intensive care patients. As an eye care intervention, the effectiveness of polyethylene cover should be supported by further studies. This study, which is an initial step in preventing dry eye syndrome in critically ill patients, also offers a new and effective eye care method in these patients.