Risk stratification, prevention and management of perioperative corneal abrasion for non-ocular surgery: Systematic Review

Abstract

Background: A corneal abrasion is a flaw in the cornea’s epithelial surface, which is located in the front of the eye. It causes recurrent erosions, corneal inflammation, and chronic corneal defects. In a context with limited resources, the goal of this review was to provide an evidence-based procedure for perioperative risk stratification, prevention, and management of corneal abrasion during non-ocular surgery. Methods: A medical search engines of PUBMED, GOOGLE SCHOLAR, COCHRANE REVIEW, and PUBMED CENTERAL to get access for current and updated evidence on procedures on risk stratification, prevention and management of corneal abrasion for non-ocular surgery. The authors formulate the key questions, scope, and articles written in English language, human study focuses on corneal abrasion, articles in the last 20 year was implemented to identify or filter high-level evidences were included. Reports contain corneal abrasion due to ocular surgery were excluded. All the research articles, which were identified from searches of electronic databases, were imported into Endnote software, duplicate were removed advanced search strategy of electronic sources from databases and websites was conducted using Boolean operators (cornea AND (abrasion OR injury OR laceration)) AND (“Perioperative Period” OR “general anesthesia”). Screening of literatures was conducted with proper appraisal checklist. This review was reported in accordance with preferred reporting items for systematic reviews and meta-analyses (PRISMA) 2020 statement. Results: From 8767 identified articles, two hundred articles were removed for duplication and 7720 studies were excluded, 1205 articles were retrieved and evaluated for eligibility. Finally, 24 were included in this systematic review. Advanced age, Prominent eyes, , exophthalmus, ocular surface abnormalities (dry eye), expected duration of surgery (>1 h), the favourable position of the surgery, prone,Trendelenburg and lateral, risk of bleeding, surgical site of the surgery(head /neck) and diabetes mellitus were risk for corneal abrasion. The use of appropriate intervention with pharmacological and Non-pharmacological strategies minimizes the occurrence of perioperative corneal abrasion was crucial for the quality of care. Conclusion: Preventing and managing corneal abrasion improves patients’ quality of life. However, there was insufficient evidence to draw conclusions, and high-quality trials of multimodal interventions matched to risk stratification and prevention of corneal abrasion needed to provide robust evidence to guide prevention and management of perioperative corneal abrasion.