Synthetic rubber sheet to manage exposure keratopathy

Ayano Yoshimura; Kaoru Araki-Sasaki; Noriko Toyokawa; Ryo Fujiwara; Kanji Takahashi; Fumi Gomi

doi:10.1016/j.ajoc.2021.101185

Synthetic rubber sheet to manage exposure keratopathy

Am J Ophthalmol Case Rep. 2021 Jul 29:23:101185. doi: 10.1016/j.ajoc.2021.101185. eCollection 2021 Sep.

Authors

Ayano Yoshimura^{1

2}, Kaoru Araki-Sasaki^{2

3}, Noriko Toyokawa⁴, Ryo Fujiwara^{2

3}, Kanji Takahashi³, Fumi Gomi¹

Affiliations

¹ Department of Ophthalmology, Hyogo College of Medicine, 1-1, Mukogawacho, Nishinomiya, Hyogo, 663-8501, Japan.
² Department of Ophthalmology, JCHO Hoshigaoka Medical Center, 4-8-1, Hoshigaoka, Hirakata, 573-8511, Japan.
³ Department of Ophthalmology, Kansai Medical University, 2-5-1, Shinmachi, Hirakata, Osaka, 573-1010, Japan.
⁴ Nagata Eye Clinic, 1147 Horai-cho, Nara, Japan.

Abstract

Purpose: Exposure keratopathy often progresses even with conventional various treatments and needs plastic surgery. However, plastic surgery of eye lid is often difficult in cases with poor general condition by cerebrovascular disorders. We will propose a novel method using synthetic rubber sheet to manage the exposure keratopathy under poor general conditions.

Observations: We treated with synthetic rubber sheet on 9 eyes of 9 patients who suffered from refractory exposure keratopathy due to cerebrovascular disorders. Sheets cut from sterile surgical gloves made of synthetic rubber (SR sheets) were placed directly onto the ocular surface with antibiotic ointment and fixed with gauze and tape. Severity of the exposure keratopathy was scored before and after the application of SR sheet. Covered ocular surface with SR sheet could keep an adequate moist environment and exposure keratopathy was improved in all the cases with no adverse effects during an average observation period of 166.2 days.

Conclusions and importance: Sterile synthetic rubber sheet cut from surgical gloves is an effective, safe, easy, and economical material to maintain better condition of ocular surface and especially useful for refractory exposure keratopathy under poor general condition.

Keywords: Corneal ulcer; Dry eye; Exposure keratopathy; Facial paralysis; Lagophthalmos; Ocular surface.