Prevalence and risk factors of exposure keratopathy among critically ill patients: A systematic review and meta-analysis.
Yulu Chen, Jing He, Qiuping Wu and 2 others
PMID 38268267WHAT IT FOUND
ICU patients commonly develop exposure keratopathy; 34% had it and 23% developed it.
Watch for incomplete eyelid closure, eye swelling, low blink rate, ventilation, sedation, low GCS, high APACHE II.
Key findings
01Pooled prevalence of exposure keratopathy in ICU patients was 34.0% across 14 studies.
02Pooled incidence was 23.0% across 11 studies.
03Lagophthalmos, chemosis, eye blinks <5 times per minute, mechanical ventilation, sedation, lower GCS score, and higher APACHE II score were significantly associated with exposure keratopathy.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
The included studies varied very widely, so the pooled prevalence and incidence estimates may not apply to every ICU. Studies used different definitions of exposure keratopathy, including mild punctate changes versus corneal ulcer or abrasion, which changed the pooled rates. Eye examinations were done with different frequency and methods, and more frequent exams found higher rates, so some studies may have missed mild cases. Risk-factor estimates did not adjust for other ICU factors such as sedation or ventilation, so they may reflect confounding rather than independent effects. Publication bias was found for prevalence studies, and some risk factors had too few studies for reliable analysis. The review did not follow discharged patients long term, so it does not show longer-term visual outcomes.
Declared interests
The authors declared no competing financial interests or personal relationships, and no funding was reported.
The easy way to misread this
Do not read the 34.0% prevalence and 23.0% incidence as exact rates for your ICU. The included studies varied very widely, used different exposure keratopathy definitions and eye-exam frequency, and the risk-factor estimates did not adjust for other ICU factors.