Int J Nurs Stud. 2008 Nov;45(11):1565-71. Epub 2008 Apr 18.

Comparing the effectiveness of polyethylene covers (Gladwrap) with lanolin

So HM, Lee CC, Leung AK, Lim JM, Chan CS, Yan WW.

Department of Intensive Care, Pamela Youde Nethersole Eastern Hospital, 3 Lok Man
Road, Chai Wan, Hong Kong, China. This email address is being protected from spambots. You need JavaScript enabled to view it.

BACKGROUND: In unconscious ventilated patients, various eye protective measures
have been used to prevent corneal abrasions. Two randomized controlled studies in
Australia had compared the effectiveness of polyethylene films and eye
instillations to prevent corneal abrasions but results were inconsistent. The
local acceptance of polyethylene films as a standard eye protective measure is
still limited. OBJECTIVES: Our study aims to compare the effectiveness of
polyethylene covers (Gladwrap) with lanolin (Duratears) eye ointment in the
prevention of corneal abrasions in critically ill patients. DESIGN: A prospective
randomized controlled study was conducted between April 2004 and December 2005.
SETTING AND PARTICIPANTS: One hundred and twenty ventilated patients admitted to
the intensive care unit (ICU) were randomly assigned to receive either
polyethylene covers or lanolin eye ointment to prevent corneal abrasions.
METHODS: All participants received a standard eye care regime together with the
eye protective interventions. A fluorescein stain test was performed by the eye
care team daily and then weekly to detect any corneal abrasions. RESULTS: Four
participants were not included in the data analysis as they died soon after
commencement of the study. A total of 116 patients were included in the final
analysis. Of the seven patients (6.0%) that had a positive fluorescein test, four
(6.8%) were in the polyethylene covers group (n=59) and three (5.3%) were in the
lanolin eye ointment group (n=57). This was not statistically significant
(p=0.519). One patient in the lanolin eye ointment group had an eye infection.
Upon follow-up of those patients with positive fluorescein test results, two
patients spontaneously converted to stain negative within 24h and two patients
died before the ophthalmologist's assessment. The remaining three patients were
diagnosed to have epithelial cell loss without corneal abrasions. CONCLUSIONS:
With the implementation of a standardized eye care protocol, polyethylene cover
is found to be equally effective in preventing corneal abrasions when compared
with lanolin eye ointment. The additional benefit of polyethylene cover as a
physical barrier to protect patients' eyes needed further evaluation.