SHOULD WE PATCH CORNEAL ABRASIONS - A METAANALYSIS

BACKGROUND. Eye patching is commonly recommended for treating corneal abrasions. This advice seems based more on anecdotes or disease-orient ed evidence theorizing that there is faster healing or less pain when the eye is patched. This meta-analysis was performed to determine if e ye patching is a useful treatment for corneal abrasions. METHODS. We c onducted a comprehensive search of both MEDLINE (1966 to 1997) and Sci ence Citation Index to locate relevant articles. We reviewed the bibli ographies of included studies, and ophthalmology and primary care text s. Local ophthalmologists and authors were contacted to identify any u npublished data. Controlled trials that evaluated eye patching compare d with no patching in patients older than 6 years with uncomplicated c orneal abrasions were considered. The outcomes of interest were healin g rates and degree of pain. RESULTS. Seven trials were identified for inclusion, of which five could be statistically combined. Healing rate s were similar in the two groups. The summary ratios (95% confidence i nterval) of healing rates in the patch group as compared with the no-p atch group were 0.87 (0.68 to 1.13) and 0.90 (0.75 to 1.10) at days 1 and 2, respectively. Six studies evaluated pain: four found no differe nce and two favored not patching. No differences in complication rates were noted between the patched and non-patched groups. CONCLUSIONS, E ye patching was not found to improve healing rates or reduce pain in p atients with corneal abrasions. Given the theoretical harm of loss of binocular vision and possible increased pain, we recommend the route o f harmless nonintervention in treating corneal abrasions.