Moisture chamber versus lubrication for corneal protection in critically ill patients: a meta-analysis

Cornea. 2014 Nov;33(11):1179-85. doi: 10.1097/ICO.0000000000000224.

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.

Publication types

  • Comparative Study
  • Meta-Analysis

MeSH terms

  • Corneal Diseases / prevention & control*
  • Critical Care / methods*
  • Critical Illness*
  • Humans
  • Humidity*
  • Intensive Care Units
  • Lubrication / methods*