Estudo comparativo entre oclusão e não-oclusão no tratamento de abrasão corneana após retirada de corpo estranho da córnea

Agostini, Rafael Mourão; Rocha, Guilherme Mourão Soares da; Miranda, Jane Claudia; Aguiar, Daniela Vieira de; Netto, João Agostini

doi:10.1590/s0004-27492004000100019

Cited by 5 publications

(6 citation statements)

References 7 publications

(20 reference statements)

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“…12,13,31,[43][44][45][46]50,51 Similarly, no significant difference existed at 48 hours in four studies. 11,31,50,51 In addition, no significant difference in use of oral NSAID use was found between patching and controls (1.4 NSAID tablets vs. 1.6 NSAID tablets; RR = 1.01, 95% CI = 0.78 to 1.29; low certainty of evidence; Figure S3e). 44,45 Among seven RCTs, there was a nonstatistically significant trend toward a higher rate of complications in the patching compared to the control group (11/204 [5.4%] vs. 3/217 [1.4%]; RR = 2.44, 95% CI = 0.33 to 17.71; low certainty of evidence; Figure S3f).…”

Section: Risk Of Biasmentioning

confidence: 79%

“…There was no significant difference in patient‐reported pain between patching and control at 24 hours in the nine studies that reported the outcome or in the four studies of the meta‐analysis (SMD = –0.07, 95% CI = –0.53 to 0.39; low certainty of evidence; Figure d) 12,13,31,43‐46,50,51 . Similarly, no significant difference existed at 48 hours in four studies 11,31,50,51 . In addition, no significant difference in use of oral NSAID use was found between patching and controls (1.4 NSAID tablets vs. 1.6 NSAID tablets; RR = 1.01, 95% CI = 0.78 to 1.29; low certainty of evidence; Figure e) 44,45 …”

Section: Resultsmentioning

confidence: 97%

“…Healing was defined as no epithelial defects or only punctate defects on slit‐lamp examination with fluorescein. Three studies also defined healing to be pain scores less than a low threshold 29‐31 . For each intervention, percentage of patients healed was also calculated at each time point using a weighted mean.…”

Section: Methodsmentioning

confidence: 99%

“…Three studies also defined healing to be pain scores less than a low threshold. [29][30][31] For each intervention, percentage of patients healed was also calculated at each time point using a weighted mean. Pain control was measured at 24 and 48 hours, with all pain scores and standard deviations (SD) converted to a 10-point continuous scale for consistency.…”

Section: Data Synthesis and Analysismentioning

confidence: 99%

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Topical pain control for corneal abrasions: A systematic review and meta‐analysis

Kirubarajan

Yau

et al. 2021

Academic Emergency Medicine

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Objectives Corneal abrasions are common ophthalmic presentations to emergency departments. Among emergency physicians and ophthalmologists, there are highly variable practice patterns with regard to management of resultant pain and discomfort. The goal of this study was to review and analyze the efficacy and safety of topical pain therapies for corneal abrasions, including topical anesthetics, nonsteroidal anti‐inflammatory drugs (NSAIDs), cycloplegics, steroids, pressure patching, and the use of a bandage contact lens (BCL). Methods The review followed the Preferred Reporting Items for Systematic Review and Meta‐analysis (PRISMA) guidelines. The protocol was established a priori and published on PROSPERO (CRD42020201288). MEDLINE, EMBASE, CENTRAL, and Web of Science were searched until December 31, 2020. Primary studies comparing topical pain therapies to another therapy or control were included. Primary outcomes included percentage of corneal abrasions healed at 24, 48, and 72 hours, as well as pain control at 24 and 48 hours. Secondary outcomes included use of oral analgesia and incidence of complications. Risk of bias was assessed using validated tools. Quality of evidence was assessed using the GRADE methodology. Results Overall, 33 studies (31 randomized controlled trials [RCTs], two cohort studies) comprising 4,167 patients with corneal abrasions were analyzed. Only the data for topical NSAIDs were of adequate evidence from which to draw conclusions; topical NSAIDs demonstrated significantly reduced pain scores at 24 hours (standardized mean differences [SMD] –0.69, 95% CI = –0.98 to –0.41) and 48 hours (SMD = –0.56, 95% CI = –1.02 to –0.10) as well as 53% (95% CI = 34% to 67%) lower oral analgesia use compared to control. Based on available data, topical anesthetics, cycloplegics, patching, and the use of a BCL did not result in any significant difference in pain scores or use of oral analgesia, while no studies examined topical steroids. No interventions resulted in healing delays or significantly higher rates of complications compared to controls. Conclusions There was strong evidence to support that topical NSAIDs reduce pain associated with corneal abrasions in the first 48 hours and the need for oral analgesia. The existing evidence was insufficient to support or refute the use of topical anesthetics, cycloplegics, steroids, or BCL for pain control in corneal abrasions. Pressure patching was ineffective at pain reduction and may increase the risk of complications. Delays in healing or other complications were not significantly different between any intervention or control for simple, uncomplicated corneal abrasions; however, larger RCTs are required to identify any differences in rare complications.

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Section: Risk Of Biasmentioning

confidence: 79%

Section: Resultsmentioning

confidence: 97%

Section: Methodsmentioning

confidence: 99%

Section: Data Synthesis and Analysismentioning

confidence: 99%

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Topical pain control for corneal abrasions: A systematic review and meta‐analysis

Kirubarajan

Yau

et al. 2021

Academic Emergency Medicine

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“…An extensive Cochrane systematic review by Turner and Rabiu [4] was conducted to determine the effects of eye patching for treating corneal abrasions. In their review of studies[5,6,7,8,9,10,11,12,13,14,15], they found no evidence for the use of eye patches for simple corneal abrasions as they did not improve day 1 postinjury healing rates nor reduce pain, and were associated with discomfort [4]. However, they observed that many of the studies did not declare a proper randomization process and had a high number of dropouts.…”

Section: Introductionmentioning

confidence: 99%

Treatment of Traumatic Corneal Abrasions: A Three-Arm, Prospective, Randomized Study

et al. 2013

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Purpose: To compare three different treatment modalities for traumatic corneal abrasions. Methods: We conducted a prospective, randomized, masked, three-arm clinical study of patients presenting with superficial corneal foreign bodies. Treatment modalities were: (1) pressure patching with ofloxacin ointment (patch group, PG, n = 18), (2) therapeutic contact lens with ofloxacin eye drops (contact lens group, CLG, n = 20) and (3) ofloxacin ointment alone (ointment group, OG, n = 28). Primary outcome measure was the difference of the mean corneal abrasion area between the three groups at 3 different time points (baseline, day 1 and day 7). Results: A total of 66 patients were included in the study over a period of 2 years. Mean initial corneal abrasion area was 3.6 ± 3.4 mm² in the PG, 4.2 ± 4.0 mm² in the CLG and 3.7 ± 3.1 mm² in the OG (p = 0.875). Differences in corneal abrasion area at any time point were not statistically significant (abrasion area decrease from presentation to day 1 was 3.4 ± 3.3 mm² in the PG, 4.1 ± 4.0 mm² in the CLG and 3.5 ± 3.1 mm² in the OG, p = 0.789). The epithelium was healed in all patients at day 7. Conclusions: Treating traumatic corneal abrasions by pressure patching, a bandage contact lens or ointment alone was equal in reducing the abrasion area or reducing pain. According to our results the treatment of choice for traumatic abrasions may be adapted to the needs and preferences of the patient.

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Patching for corneal abrasion

Turner

Rabiu

2006

Cochrane Database of Systematic Reviews

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Estudo comparativo entre oclusão e não-oclusão no tratamento de abrasão corneana após retirada de corpo estranho da córnea

Cited by 5 publications

References 7 publications

Topical pain control for corneal abrasions: A systematic review and meta‐analysis

Topical pain control for corneal abrasions: A systematic review and meta‐analysis

Treatment of Traumatic Corneal Abrasions: A Three-Arm, Prospective, Randomized Study

Patching for corneal abrasion

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