Corneal abrasion in patient having nonocular surgery under general anesthesia in prone position

Abstract

Aim; The most common ophthalmologic injury which is seen in patient having nonocular surgery under general anesthesia is corneal ahrasion. Corneal protection may in principles be conveyed by taping the eye lids closed, and by application of ocular lubricants into the conjunctiva sac. Though there is a lot of study in the literature, comparing the efficiency of the different eye protection methods in supine position patient, there are only few documented study comparing the eye protection methods in the face-down prone position. This study was organized in order to find out the efficiency of the four different eye protection methods on preventing the corneal abrasions and to compare the side effects of these methods in patient having nonocular surgery under general anesthesia in prone position. Materials and Methods: After having the ethical approval from the ethical committee, 120 patients (240 eyes) were enrolled in this study. Patients were divided into four different eye protection groups, consisting of eye goggle, cotton eye pads, cot ton eye pads with ophthalmic eye gel and cotton eye pads with ophthalmic ointment. Thirty minutes, six hours and twenty four hours after surgery, the patients' eye symptoms (adhesive lids, foreign body sensation, itching, redness of the conjunctiva, blurred vision, pain sensation) were evaluated and corneal abrasions were examined with fluorescein staining test by an ophthalmologist. Results: Corneal abrasion rates were similar between groups (p>0.05). There was no significant difference between groups according to adhesive lids (p>0.05). High incidence of blurred vision and foreign body sensation were obtained in the cotton eye pads with ointment group. High incidence of conjunctiva hyperemia and itching sensation were obtained in the cotton eye pads with eye gel group according to other groups (p<0.05). None of the patients in all groups had pain sensation in postoperative period. Conclusion: In conclusion all of the methods which are compared avoid the eyes ideally from the corneal abrasion in prone position patient having operation under general anesthesia, but using eye gel or ointment with the cotton eye pads have no positive effect on prevention of corneal abrasion and also have some unwanted side effects.