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Corneal protection during general anesthesia for nonocular surgery

机译：非眼科手术全麻时的角膜保护

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摘要

Corneal abrasion is the most common ophthalmologic complication that occurs during general anesthesia for nonocular surgery. Such abrasions can be caused by a variety of mechanisms and can lead to sightthreatening microbial keratitis and permanent scarring. There is no standard mode of protecting the cornea during general anesthesia for nonocular surgery. Methods described in the literature are not entirely effective and may be associated with unwanted side effects. Taping alone provides protection that is equivalent or superior to other interventions and has fewer side effects. Petroleum gel is flammable and is best avoided when electrocautery and open oxygen are to be used around the face. Preservativefree eye ointment is preferred, as preservative can cause corneal epithelial sloughing and conjunctival hyperemia. Recently, the application of Geliperm and bio-occlusive dressings has been advocated. Geliperm may be particularly useful during endonasal surgery when continuous perioperative observation of the eye is required. In this article, the literature on the etiology of perioperative corneal abrasions is reviewed and various protection strategies are compared in order to identify the best methods to prevent corneal abrasions during general anesthesia.
机译：角膜擦伤是非眼外科手术全麻期间最常见的眼科并发症。这种擦伤可能是由多种机制引起的，并可能导致威胁视力的微生物性角膜炎和永久性瘢痕形成。没有用于非眼科手术的全麻过程中保护角膜的标准模式。文献中描述的方法并不完全有效，并且可能与不良副作用相关。单独进行录音可以提供与其他干预措施相当或更高的保护作用，并且副作用更少。石油凝胶易燃，当在脸部周围使用电灼和开放式氧气时，最好避免使用。首选无防腐剂的眼药膏，因为防腐剂会导致角膜上皮脱落和结膜充血。近来，已经提倡使用格列本和生物封闭敷料。当需要连续围手术期观察眼睛时，胶状体在鼻内手术期间可能特别有用。在本文中，回顾了围手术期角膜擦伤的病因文献，并比较了各种保护策略，以确定在全身麻醉期间预防角膜擦伤的最佳方法。

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