Sutureless Amniotic Membrane Transplantation Using Pediatric Nasogastric Tube For Patients With Intensive Care Unit

The aim of this study is to evaluate the results of patients who underwent eyelid taping and pediatric nasogastric tube (NGT) and sutureless amniotic membrane transplantation (AMT) due to exposure keratopathy seen in patients admitted to intensive care units in our tertiary center.

Patients hospitalized in the intensive care unit and consulted to the ophthalmology clinic between December 2022 and February 2023 were retrospectively analyzed. Exposure keratopathy was detected in 23 of 119 patients for whom eye consultation was requested. Red eye was the reason for the consultation request in all patients with exposure keratopathy. Eyelid taping and preservative-free artificial tears were applied to 23 patients. AMT was applied to 8 patients who did not improve with this treatment. The results of the patients were evaluated.

The mean age of the patients was 51.09±18.3 (range: 24-82). Five of the patients were female and 18 were male. eyelid taping was applied to 15 patients and AMT was applied to 8 patients who did not heal with closure. AMT was repeated 2-4 times for each patient. Keratitis developed in 2 patients and perforation developed in 1 patient. Cyanoacrylate and AMT were applied to the patient who developed perforation. Three patients who underwent eyelid taping and one patient who underwent AMT died. Ocular surface improved in 12 patients who underwent eyelid taping. 3 patients who underwent AMT recovered with corneal scarring, and 4 patients did not apply to the eye outpatient clinic after released intensive care unit.

While ensuring the survival of the patient in the intensive care unit, attention should be paid to ocular morbidities. Intensive care unit patients are usually in a state of sedation as they receive anesthesia, resulting in the eyelids not closing properly and the development of exposure keratopathy. If left untreated, it can lead to serious complications such as exposure keratopathy, microbial keratitis, corneal perforation and visual impairment. Sutureless AMT is a low-cost, easy-to-apply and non-invasive AMT technique. We think that it is a safe and effective treatment for exposure keratopathy, especially in intensive care patients who cannot be operated.