Ocular surface injuries at an intensive care unit: a self-paired clinical trial

Objective: To analyze the occurrence of ocular surface injuries at an intensive care unit in patients who were sedated or unable to blink. Methods: Self-paired clinical trial carried out at the intensive care unit of a hospital in the northwest region of the state of Parana, Brazil, between July 2016 and January 2017. Twenty-seven patients who did not have previous ocular injuries, submitted to bilateral eye cleaning with 0.9% salt solution and occlusion of the right eye with transparent polyurethane film, participated in the study. The association of occurrence of ocular injuries with demographic, clinical, care, and environmental variables was investigated by applying Fisher's exact test, and a comparison of the injury-free time (in days) with and without using the eyeshield was performed by using Wilcoxon test. Results: Ocular injuries were associated with fasting (p=0.0039), lower risk of death (p=0.0056), and longer hospital stay (p=0.0088). The occlusion of the right eye with transparent polyurethane film was considered a protection factor (p=0.0019) and was associated with a longer injury-free time in the right eye (4.1 days) in comparison with the result obtained for the left eye (2.4 days) (p=0.00222). Conclusion: In the analyzed intensive care unit. ocular occlusion proved effective in protecting the eye, especially in patients who were fasting, had a higher probability of surviving, and went through a longer hospital stay.