Comparison of bandage contact lens removal on the fourth versus seventh postoperative day after photorefractive keratectomy: A randomized clinical trial

Mohammadpour, Mehrdad; Shakoor, Delaram; Hashemi, Hassan; Meybodi, Mohamad Aghaie; Rajabi, Fateme; Hosseini, Pegah

doi:10.1016/j.joco.2016.08.008

Cited by 16 publications

(13 citation statements)

References 31 publications

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“…Bandage contact lenses are soft lenses that are placed in the patient's eye for night and day use until removed by the practitioner. They are frequently used in ophthalmic corneal surgery under the premise that they enhance patient comfort and healing 59 . Our literature search identified only a limited number of studies evaluating this treatment in patients with traumatic corneal abrasions and as such there is insufficient evidence to support or refute benefits to healing or pain control.…”

Section: Discussionmentioning

confidence: 99%

“…They are frequently used in ophthalmic corneal surgery under the premise that they enhance patient comfort and healing. 59 Our literature search identified only a limited number of studies evaluating this treatment in patients with traumatic corneal abrasions and as such there is insufficient evidence to support or refute benefits to healing or pain control. While the included studies found no complications, infectious keratitis was reported in two prior case series in the treatment of corneal abrasions.…”

Section: Discussionmentioning

confidence: 99%

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Topical pain control for corneal abrasions: A systematic review and meta‐analysis

Kirubarajan

Yau

et al. 2021

Academic Emergency Medicine

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Objectives Corneal abrasions are common ophthalmic presentations to emergency departments. Among emergency physicians and ophthalmologists, there are highly variable practice patterns with regard to management of resultant pain and discomfort. The goal of this study was to review and analyze the efficacy and safety of topical pain therapies for corneal abrasions, including topical anesthetics, nonsteroidal anti‐inflammatory drugs (NSAIDs), cycloplegics, steroids, pressure patching, and the use of a bandage contact lens (BCL). Methods The review followed the Preferred Reporting Items for Systematic Review and Meta‐analysis (PRISMA) guidelines. The protocol was established a priori and published on PROSPERO (CRD42020201288). MEDLINE, EMBASE, CENTRAL, and Web of Science were searched until December 31, 2020. Primary studies comparing topical pain therapies to another therapy or control were included. Primary outcomes included percentage of corneal abrasions healed at 24, 48, and 72 hours, as well as pain control at 24 and 48 hours. Secondary outcomes included use of oral analgesia and incidence of complications. Risk of bias was assessed using validated tools. Quality of evidence was assessed using the GRADE methodology. Results Overall, 33 studies (31 randomized controlled trials [RCTs], two cohort studies) comprising 4,167 patients with corneal abrasions were analyzed. Only the data for topical NSAIDs were of adequate evidence from which to draw conclusions; topical NSAIDs demonstrated significantly reduced pain scores at 24 hours (standardized mean differences [SMD] –0.69, 95% CI = –0.98 to –0.41) and 48 hours (SMD = –0.56, 95% CI = –1.02 to –0.10) as well as 53% (95% CI = 34% to 67%) lower oral analgesia use compared to control. Based on available data, topical anesthetics, cycloplegics, patching, and the use of a BCL did not result in any significant difference in pain scores or use of oral analgesia, while no studies examined topical steroids. No interventions resulted in healing delays or significantly higher rates of complications compared to controls. Conclusions There was strong evidence to support that topical NSAIDs reduce pain associated with corneal abrasions in the first 48 hours and the need for oral analgesia. The existing evidence was insufficient to support or refute the use of topical anesthetics, cycloplegics, steroids, or BCL for pain control in corneal abrasions. Pressure patching was ineffective at pain reduction and may increase the risk of complications. Delays in healing or other complications were not significantly different between any intervention or control for simple, uncomplicated corneal abrasions; however, larger RCTs are required to identify any differences in rare complications.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Topical pain control for corneal abrasions: A systematic review and meta‐analysis

Kirubarajan

Yau

et al. 2021

Academic Emergency Medicine

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“…The removal of BCL on the seventh postoperative day had lower pain scores compared with the removal on the fourth postoperative day (P¼0.07). 46 Considerable reduction in pain was observed on the third postoperative day compared with the first postoperative day, with the pain tapering off from the fourth day with lotrafilcon B, comfilcon A, lotrafilcon A, balafilcon A, and senofilcon A eyes. 9,19,34,[37][38][39][40] Lesser pain was observed with senofilcon A on the first postoperative day compared with other BCLs.…”

Section: Photorefractive Keratectomymentioning

confidence: 94%

“…9 Uncorrected visual acuity (UCVA) was improved considerably on the seventh postoperative day with BCL application. 43 The removal of BCL on the seventh postoperative day was beneficial compared with that on the fourth postoperative day 46 in visual rehabilitation (corrected distance visual acuity and uncorrected distance visual acuity; P¼0.016) after 1 month. A similar study showed that the removal of BCL on the third or fifth postoperative day yielded no significant benefits in visual acuity.…”

Section: Photorefractive Keratectomymentioning

confidence: 99%

Performance of Bandage Contact Lens in Patients Post-ocular Surgeries: A Systematic Literature Review

Zheng,

Zhai

2023

Eye &Amp; Contact Lens: Science &Amp; Clinical Practice

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This study systematically reviewed the performance of bandage contact lenses (BCL) such as lotrafilcon A, lotrafilcon B, senofilcon A, balafilcon A, and comfilcon A as postoperative treatment in different ocular surgeries. A systematic search of English and Chinese databases (from inception to December 2021) was conducted for studies reporting the efficacy of BCLs after ocular surgeries. Postoperative symptoms, corneal healing, and visual outcomes were studied. Overall, 38 studies were identified. Bandage contact lens was applied as a postoperative aid in corneal refractive, cataract, and vitrectomy surgeries. Most studies were on photorefractive keratectomy. Reduced postoperative symptoms were observed within 4 hr to 3 days, whereas re-epithelization of the cornea and healing was complete within 3 to 7 days after ocular surgeries except for vitrectomy. In a vitrectomy, greater comfort and improved corneal epithelium were observed on the seventh day after surgery. An improvement in dry eye symptoms was observed at 7 days with considerable benefits observed after 1 month of cataract surgery. These findings indicate that BCLs are effective for improving postoperative symptoms and facilitation of early visual rehabilitation with a wear time of 8 hr to 7 days depending on the type of ocular surgery.

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“…To further investigate the parameters associated with BSCL wear and pain control, a prospective study examined the timing of BSCL removal in 260 eyes of 130 patients, removing the lens either on day 4 or day 7 post-operatively [105]. They found no differences in pain between the two groups, although interestingly, the group in which the BSCL was removed on day 4 post-op had an increase in the frequency of complications, including filamentary keratitis, corneal erosion, and haze.…”

Section: Photorefractive Keratectomy (Prk)mentioning

confidence: 99%

BCLA CLEAR – Medical use of contact lenses

Jacobs

Carrasquillo²,

Cottrell

et al. 2021

Contact Lens and Anterior Eye

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The medical use of contact lenses is a solution for many complex ocular conditions, including high refractive error, irregular astigmatism, primary and secondary corneal ectasia, disfiguring disease, and ocular surface disease. The development of highly oxygen permeable soft and rigid materials has extended the suitability of contact lenses for such applications. There is consistent evidence that bandage soft contact lenses, particularly silicone hydrogel lenses, improve epithelial healing and reduce pain in persistent epithelial defects, after trauma or surgery, and in corneal dystrophies. Drug delivery applications of contact lens hold promise for improving topical therapy. Modern scleral lens practice has achieved great success for both visual rehabilitation and therapeutic applications, including those requiring retention of a tear reservoir or protection from an adverse environment. This report offers a practical and relevant summary of the current evidence for the medical use of contact lenses for all eye care professionals including optometrists, ophthalmologists, opticians, and orthoptists. Topics covered include indications for use in both acute and chronic conditions, lens selection, patient selection, wear and care regimens, and recommended aftercare schedules. Prevention, presentation, and management of complications of medical use are reviewed.

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Comparison of bandage contact lens removal on the fourth versus seventh postoperative day after photorefractive keratectomy: A randomized clinical trial

Cited by 16 publications

References 31 publications

Topical pain control for corneal abrasions: A systematic review and meta‐analysis

Topical pain control for corneal abrasions: A systematic review and meta‐analysis

Performance of Bandage Contact Lens in Patients Post-ocular Surgeries: A Systematic Literature Review

BCLA CLEAR – Medical use of contact lenses

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