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Moisture Chamber Versus Lubrication for Corneal Protection in Critically Ill Patients: A Meta-Analysis

Zhou, Yun MMed*; Liu, Jing BMed; Cui, Yun; Zhu, Hechen BMed§; Lu, Zhaozeng MD, PhD

Cornea:
doi: 10.1097/ICO.0000000000000224
Clinical Science
Abstract

Purpose: Critically ill patients in the intensive care unit are at increased risk of exposure keratopathy. There is limited evidence available to make the best choice of eye care modality. This meta-analysis aimed to evaluate the effect of moisture chamber compared with lubrication for corneal protection in critically ill patients.

Methods: Studies were identified through PubMed, Embase, The Cochrane Library, and complementary manual searches, up to May 31, 2014. Randomized controlled trials of critically ill patients in the intensive care unit comparing moisture chamber with lubrication and evaluating risk of corneal damage were included.

Results: Seven trials were included. The pooled analysis showed that the use of moisture chambers resulted in a reduction of the incidence of corneal damage [risk ratio (RR), 0.27; 95% confidence interval (CI): 0.11–0.67; P = 0.005]. In 1 subgroup analysis, there was a significant difference between the use of moisture chambers and lubricating drops, and the moisture chamber group had a decreased incidence of corneal damage (RR, 0.13; 95% CI: 0.05–0.35; P < 0.0001). In the other subgroup analysis, no statistically significant difference was observed between the use of moisture chambers and lubricating ointments (RR, 0.81; 95% CI: 0.51–1.29; P = 0.38). The overall quality of evidence was low.

Conclusions: The use of moisture chambers is associated with more effective corneal protection compared with lubrication. The analytic result is limited by serious risk of bias and imprecision.

Author Information

*Department of Intensive Care Unit, Huashan Hospital Affiliated to Fudan University, Shanghai, China;

Department of Intensive Care Unit, Zhenjiang First People's Hospital, Jiangsu, China; and

Departments of Nursing,

§Intensive Care Unit, and

Ophthalmology, Huashan Hospital Affiliated to Fudan University, Shanghai, China.

Reprints: Zhaozeng Lu, MD, PhD, Department of Ophthalmology, Huashan Hospital Affiliated to Fudan University, 12 Middle Wulumuqi Rd, Shanghai 200040, China (e-mail: zhaozenglu@163.com).

The authors have no funding or conflicts of interest to disclose.

Received March 31, 2014

Received in revised form June 24, 2014

Accepted June 28, 2014

© 2014 by Lippincott Williams & Wilkins.