{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,3]],"date-time":"2026-10-03T07:41:18Z","timestamp":1791013278699,"version":"4.1.0"},"reference-count":36,"publisher":"Public Library of Science (PLoS)","issue":"4","license":[{"start":{"date-parts":[[2021,4,1]],"date-time":"2021-04-01T00:00:00Z","timestamp":1617235200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100004697","name":"Hamadan University of Medical Sciences","doi-asserted-by":"publisher","award":["IR.UMSHA.REC.1395.262"],"award-info":[{"award-number":["IR.UMSHA.REC.1395.262"]}],"id":[{"id":"10.13039\/501100004697","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["www.plosone.org"],"crossmark-restriction":false},"short-container-title":["PLoS ONE"],"abstract":"<jats:sec id=\"sec001\"><jats:title>Background<\/jats:title><jats:p>Polyethylene covers are claimed to be useful in preventing ocular surface diseases (OSD); however, evidence of their clinical efficacy is limited. This clinical trial aimed to compare the use of polyethylene eye covers and artificial teardrops versus normal saline on the incidence and severity of OSD in comatose patients.<\/jats:p><\/jats:sec><jats:sec id=\"sec002\"><jats:title>Methods<\/jats:title><jats:p>Of 90 eligible patients randomly assigned to three treatment groups, 79 patients completed the study, In group A, patients (n = 25) received artificial teardrops for left and normal saline for right eyes, in group B (n = 29) polyethylene covers for left and normal saline for right eyes, and in group C (n = 25) polyethylene covers for left and artificial teardrops for right eyes. As the patients were comatose, their blinding did not applicable, and a blinded observer evaluated the patients\u2019 eyes based on the Corneal Fluorescein Staining Pattern. The blinded analyzer analyzed collected data by SPSS-16 software at a 95% confidential level.<\/jats:p><\/jats:sec><jats:sec id=\"sec003\"><jats:title>Results<\/jats:title><jats:p>The OSDs were observed in 65 (41.14%) out of 158 eyes examined. The artificial teardrop was more effective than the normal saline in group A, polyethylene eye cover was more useful than the normal saline in group B, and polyethylene eye cover was more effective than the artificial teardrop in group C in reducing the incidence of OSD (p&lt; 0.01). Polyethylene eye covers had the most impact on reducing the severity of the OSD compared to the other interventions (p&lt; .001).<\/jats:p><\/jats:sec><jats:sec id=\"sec004\"><jats:title>Conclusions<\/jats:title><jats:p>Polyethylene eye covers significantly reduced the incidence and severity of OSD. Using polyethylene cover is suggested as a safe, effective, and accessible eye care intervention for preventing OSD in comatose patients.<\/jats:p><\/jats:sec><jats:sec id=\"sec005\"><jats:title>Trial registration<\/jats:title><jats:p>(<jats:ext-link xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" ext-link-type=\"uri\" xlink:href=\"http:\/\/www.irct.ir\/searchresult.php?id=9014&amp;number=115\" xlink:type=\"simple\">IRCT201609129014N115<\/jats:ext-link>), Iranian Registry of Clinical Trials.<\/jats:p><\/jats:sec>","DOI":"10.1371\/journal.pone.0248830","type":"journal-article","created":{"date-parts":[[2021,4,1]],"date-time":"2021-04-01T18:12:11Z","timestamp":1617300731000},"page":"e0248830","update-policy":"https:\/\/doi.org\/10.1371\/journal.pone.corrections_policy","source":"Crossref","is-referenced-by-count":15,"title":["Polyethylene eye-cover versus artificial teardrops in the prevention of ocular surface diseases in comatose patients: A prospective multicenter randomized triple-blinded three-arm clinical trial"],"prefix":"10.1371","volume":"16","author":[{"given":"Mahnaz","family":"Khatiban","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hamid","family":"Moradi Amin","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gholamhosein","family":"Falahinia","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Abbas","family":"Moghimbeigi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mehran","family":"Yadollahi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"340","published-online":{"date-parts":[[2021,4,1]]},"reference":[{"issue":"1","key":"pone.0248830.ref001","doi-asserted-by":"crossref","first-page":"29","DOI":"10.1111\/j.1365-2702.2008.02388.x","article-title":"Factors related to incidence of eye disorders in Korean patients at intensive care units","volume":"18","author":"EG Oh","year":"2009","journal-title":"Journal of Clinical Nursing"},{"issue":"5","key":"pone.0248830.ref002","doi-asserted-by":"crossref","first-page":"1088","DOI":"10.1590\/S0104-11692011000500005","article-title":"Corneal injuries: incidence and risk factors in the Intensive Care Unit","volume":"19","author":"A Werli-Alvarenga","year":"2011","journal-title":"Revista latino-americana de enfermagem"},{"issue":"8","key":"pone.0248830.ref003","doi-asserted-by":"crossref","first-page":"589","DOI":"10.3390\/diagnostics10080589","article-title":"Novel Approaches for Imaging-Based Diagnosis of Ocular Surface Disease","volume":"10","author":"D Schmidl","year":"2020","journal-title":"Diagnostics (Basel)"},{"key":"pone.0248830.ref004","doi-asserted-by":"crossref","first-page":"e14","DOI":"10.1016\/j.apnr.2015.05.016","article-title":"Evidence of interventions for the risk of dry eye in critically ill patients: An integrative review","volume":"29","author":"CFSM de Fran\u00e7a","year":"2016","journal-title":"Applied Nursing Research"},{"issue":"6","key":"pone.0248830.ref005","doi-asserted-by":"crossref","first-page":"311","DOI":"10.1177\/0885066613510674","article-title":"Making a difference in eye care of the critically ill patients","volume":"30","author":"MA Alansari","year":"2015","journal-title":"Journal of Intensive Care Medicine"},{"issue":"4","key":"pone.0248830.ref006","first-page":"323","article-title":"Comparing the effectiveness of two methods of eye care in the prevention of ocular surface disorders in patients hospitalized in intensive care unit","volume":"10","author":"M Ahmadi-Nejad","year":"2013","journal-title":"Annals of Military and Health Sciences Research"},{"issue":"2S","key":"pone.0248830.ref007","first-page":"16","article-title":"Comparison of three methods of wet gauze, adhesive tape and eye ointment to prevent corneal ulceration in pationts undergoing general anestesia","volume":"8","author":"M Ghanei","year":"2016","journal-title":"Journal of Fundamental and Applied Sciences"},{"issue":"1","key":"pone.0248830.ref008","doi-asserted-by":"crossref","first-page":"38","DOI":"10.1016\/j.iccn.2013.08.001","article-title":"Effective management of exposure keratopathy developed in intensive care units: The impact of an evidence based eye care education programme","volume":"30","author":"S Demirel","year":"2014","journal-title":"Intensive and Critical Care Nursing"},{"issue":"2","key":"pone.0248830.ref009","doi-asserted-by":"crossref","first-page":"4423","DOI":"10.9789\/2175-5361.2016.v8i2.4423-4434","article-title":"Risk factors for injury in the cornea in critical patients in intensive care: an integrative review. 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