Protection of the Eyes With Ophthalmic Ointments During General Anaesthesia

Abstract

In a double blind trial 47 anaesthetized patients were given eye protection with the paraffin-based neutral eye ointment Ph. Nord. 63 in one eye and the water-based Methyl cellulose (MC) 4% in the other. Twenty-four hours later the eyes were vital-stained with rose bengal/fluorescein. No unintended effects of the ointments were found and no injury to the eyes were seen. Compared with the paraffin-based ointment the MC ointment produced a more firm adhesion of the eyelids. A water-based 4% MC ointment is therefore as alternative to the fat-based neutral eye ointment.

Perioperative Corneal Abrasion: Updated Guidelines for Prevention and Management

“…Studies comparing various types of lubricants fail to demonstrate differences in efficacy [25][26][27][28] ; however, preservative-free methylcellulose-based ointments are preferred. Paraffin-based (petroleum) ointments disrupt tear film stability (decrease breakup time), carry a higher risk of eye irritation (blurred vision, foreign body sensation, and photophobia), and are flammable.…”

“…25,30 Methylcellulosebased ointments create firm adhesion between upper and lower lids, which may also support ocular surface moisture by preventing tear film evaporation. 26,27 Many commonly used preservatives can irritate the ocular surface 25,28 ; therefore, preservative-free preparations are recommended. Gelatinous lubricants have also been described for perioperative use.…”

The Comparison of Four Different Methods of Perioperative Eye Protection under General Anesthesia in Prone Position

“…It was reported that there was no difference between methylcellulose and paraffin-based ointment regarding protection in eyes. [6] Batra and Bali [5] reported 44% of corneal epithelial defects in the lower third of the cornea due to inadequate lid closure and these defects could be prevented by taping and applying vaseline gauze. Orlin et al [9] reported deterioration in visual acuity in 5 of 76 patients after the surgery and they further observed that visual acuity in these five patients returned to baseline within 24 hr.…”

“…Corneal protection may in principles be conveyed by taping the eye lids closed, and by application of ocular lubricants into the conjunctiva sac. The incidence of corneal epithelial defect during GA has been reported to be 44% [5] in unprotected eyes and 2.1% [6] in eyes protected with ointment. Though there is a lot of study in the literature, comparing the efficiency of the different eye protection methods in supine position, there are only few documented study comparing the eye protection methods in the face-down prone position and to the best of our knowledge there are no studies comparing the efficacy of eye protection strategies on preventing the corneal abrasions and to compare the side effects of these methods under similar conditions with regard to severity of the lesions in cornea and conjunctiva by a scoring system in prone position .…”

Perioperative eye protection under general anesthesia

“…While Schmidt and Boggild-Madsen[6] reported no difference between methylcellulose and paraffin-based ointment, others found methylcellulose 4% to provide better eye protection. [2] Manecke et al .…”