A randomised controlled study of the effecacy of hypromellose and lacri-Lube combination versus polyethylene/clingwrap to prevent corneal epithelial breakdown in the semiconscious intensive care patient

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. © Springer-Verlag 2004.