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Bandage contact lens exchange and pain and healing after photorefractive keratectomy: a randomized control trial

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First Author: F.Aldahash SAUDI ARABIA

Co Author(s):    M. Ahad   A. AlAmeer   O. BenHusain   R. Khandekar   A. Ahmed        

Abstract Details

Purpose:

To evaluate the corneal re-epithelialization and patient perceived pain after bandage contact lens (BCL) exchange on 1 day after photorefractive keratectomy (PRK)

Setting:

King Khaled Eye specialist Hospital (KKESH), Riyadh, Saudi Arabia.

Methods:

In this randomized controlled trial (RCT), patients undergoing bilateral either (laser assisted) transepithelial-PRK (trans-PRK) or alcohol debridement and PRK (A-PRK), with mitomycin C between March and October 2019 were enrolled. One eye of each patient was randomly assigned to BCL exchange on1 day after surgery (exchange Gr1). In the other eye, the BCL was kept without exchange (comparison, Gr2). Patients were evaluated daily for first 5 days. At each visit, the corneal epithelial defect was measured until healing was complete and the BCL was removed. A questionnaire was used to assess pain, photophobia and excessive tearing.

Results:

Fifty six patients were studied (mean age 27.2±5.7 years). Trans-PRK (19; 33.9%) and A-PRK (36; 64.3%) were performed. At day 3, 40 (71.4%) eyes of Gr1 healed completely compared to 38 (67.9%) eyes of Gr2 (P=0.5). Corneal re-epithelialization rate in both groups was not significantly different (P =0.6). At day-1 follow up, the pain score was 1.87±1.4 in Gr1 and 2.29±1.3 in the Gr 2 (P=0.009). The mean pain score was 1.58±1.4 among patients who underwent alcohol debridement and PRK (A-PRK) and 2.35±1.2 among patients operated by trans-PRK (P=0.04).

Conclusions:

The epithelial healing does not vary if BCL is exchanged one day after refractive surgery. However, pain after PRK was less after BCL exchange. Compared to A-PRK, trans-PRK increased the pain score in the early postoperative phase.

Financial Disclosure:

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