Efficacy of two silicone-hydrogel contact lenses for bandage use after photorefractive keratectomy

Abstract

Purpose: To evaluate the efficacy of two silicone hydrogel (SiH) contact lenses, approved for continuous wear for one week, following photorefractive keratectomy (PRK).

Methods: Forty seven myopic patients (94 eyes) undergone bilateral PRK were enrolled in this prospective, double-masked, comparative study. One eye of each patient was fitted with a Lotrafilcon B lens (Ciba Vision, Duluth, US; 30-day recommended replacement) whereas the fellow eye was fitted with an Asmofilcon A lens (Menicon, Nagoya, Japan; 14-day recommended replacement). Epithelial defect size was assessed using slit lamp biomicroscopy on the day of surgery and at days 1-4 post-operatively. Uncorrected and best-corrected visual acuity and retinal straylight (C-Quant, Oculus Optigerate, Germany) were evaluated pre-operatively and one month post-operatively.

Results: Average epithelial defect size for Asmofilcon A and Lotrafilcon B was 25.5±11.0mm(2) vs. 27.1±9.9mm(2) at day 1 (p=0.007) and 6.3±7.0mm(2) vs. 9.2±9.5mm(2) at day 2 (p=0.012) post-operatively. Re-epithelialization at day 3 was completed in 87.2% of the eyes fitted with Asmofilcon A lenses, compared to 74.5% with Lotrafilcon B lenses (p=0.012). At the 3rd post-operative day 29.8% of re-epithelialized eyes showed irregular suture with Lotrafilcon B, compared to 12.8% eyes with Asmofilcon A lenses (p<0.001). Finally, no statistically significant differences were found post-operatively between the two lenses retinal straylight (p=0.98) and best-corrected visual acuity (p=0.68).

Conclusions: SiH lenses can be used as an effective bandage after PRK due to the limited time requested for achieving complete corneal re-epithelialization. Faster and smoother epithelial healing is provided with Asmofilcon A over Lotrafilcon B lenses.

Keywords: Bandage; Contact lens; Epithelial healing; PRK; Silicone-hydrogel.