Clinical Observation of Silicon Hydrogel Contact Lens Fitted Immediately after Small Incision Lenticule Extraction (SMILE)

Abstract

Purpose. To examine the immediate use of bandage contact lenses (BCLs) for improving patient comfort after small incision lenticule extraction (SMILE) surgery. Methods. This is a prospective randomized controlled study in which one hundred and seventy-eight patients undergoing SMILE were randomly allocated to three groups: group A wore BCLs for 8 hours postsurgery, group B wore BCLs for 24 hours postsurgery, and group C did not wear any BCLs postsurgery. Eight subjective symptoms including photophobia, tearing, pain, foreign body sensation, burning, blurred vision, sting, and dry eyes were prospectively evaluated at 2 hours, 4 hours, 8 hours, and 24 hours, using a questionnaire with a total score of 24. The scores of symptoms and signs were compared between the three groups. Results. There was a statistically significant time effect on scoring, which implicated a decline in symptoms over time after surgery (P<0.001). There was also a significant interaction between time and the treatment group (P<0.01). The total symptom score of groups A and B (5.85 ± 3.97 and 5.99 ± 4.67, respectively) was significantly lower than that of group C at 2 hours postsurgery (7.35 ± 4.86, P<0.05), especially in tearing and pain (P<0.05). The level of corneal oedema at 24 hours postsurgery was also statistically significantly different between the three groups (P<0.001), and the post hoc test showed that groups A and B were lower than group C (P<0.01). Conclusion. Silicon hydrogel BCLs applied immediately after SMILE surgery can relieve postsurgical symptoms of tearing and pain, improving overall patient comfort, and reduce corneal oedema. This trial is registered with ChiCTR-ONRC-13003114. Precis. The application of silicone hydrogel bandage contact lenses immediately after SMILE surgery has the potential to improve patient comfort, corneal healing, and patient satisfaction following SMILE.

Incidence and Management of Epithelial-Related Complications After SMILE

“…BCLs are frequently used to alleviate discomfort after various laser refractive surgeries, especially PRK, but few studies have examined their use after SMILE. 22 However, Wang et al explored this question and found that short-term use of BCL after SMILE provides comfort and pain relief, supporting our recommendation. 22 Presentations of epithelial defects in our retrospective review included sections of the epithelium with a break or loose cells larger than an area of 2.0 mm x 2.0 mm.…”

“…22 However, Wang et al explored this question and found that short-term use of BCL after SMILE provides comfort and pain relief, supporting our recommendation. 22 Presentations of epithelial defects in our retrospective review included sections of the epithelium with a break or loose cells larger than an area of 2.0 mm x 2.0 mm. 9 Previous studies have shown that epithelial defects after refractive surgery are heightened by certain risk factors, such as anterior basement membrane dystrophy and recurrent corneal erosion.…”

Long-Term Observation of Higher-Order Aberrations and Microdistortions in Bowman’s Layer After Small Incision Lenticule Extraction for the Correcting Myopia With Spherical Equivalent Higher Than −9.0 Diopters

“…Thus, this contact lens might not adhere to the cornea tightly, especially to the central optical zone postoperatively. Moreover, research showed that this contact lens may also reduce corneal edema at 24 h postoperatively (34). We assume this might also decrease the potential impact to the cornea.…”

Role of therapeutic contact lenses in management of corneal disease

“…A prospective randomized controlled study by Wang et al reported the benefits of a BCL on postprocedure pain and corneal edema after small incision lenticule extraction [37]. Contact lenses decreased postoperative pain at 2 h, but there was no difference by 4 h.…”