Purpose To investigate the change in tear production associated with general anesthesia and the protective effect of vitamin A palmitate eye gel on the ocular surface during general anesthesia. Methods This double-blind, randomized clinical trial included patients undergoing non-ophthalmic surgery under general anesthesia who randomly received vitamin A palmitate eye gel and taping for one eye (Group A, n = 60) or taping alone for the other eye (Group B, n = 60). Symptom assessment in dry eye (SANDE) score, tear film break-up time (TBUT), corneal fluorescein staining (CFS) score, and Schirmer tear test I (STT-1) were analyzed under a hand-held slit lamp before anesthesia (T 0 ), 0.5 h postoperatively (T 1 ), and 24 h postoperatively (T 2 ). Results At 0.5 h postoperatively, an increase in CFS score was observed in both groups ( P < 0.05 in Group A and P < 0.01 in Group B), and the participants in Group A had less corneal abrasions than those in Group B. STT-1 significantly increased in Group A ( P < 0.05), while it significantly decreased in Group B ( P < 0.001). The changes between the two groups were statistically significant ( P < 0.001). At 24 h postoperatively, both CFS score and STT-1 almost returned to baseline levels in the two groups. In both groups, the SANDE score and TBUT showed little change at 0.5 h and 24 h postoperatively (all P > 0.05). Conclusion Vitamin A palmitate eye gel effectively protected the ocular surface and aqueous supplementation during general anesthesia. Trial registration This study was registered in the Chinese Clinical Trial Registry (ChiCTR2100052140) on 20/10/2021.
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