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

PurposeTo evaluate the efficacy of two silicone hydrogel (SiH) contact lenses, approved for continuous wear for one week, following photorefractive keratectomy (PRK).MethodsForty 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.ResultsAverage epithelial defect size for Asmofilcon A and Lotrafilcon B was 25.5 ± 11.0 mm2 vs. 27.1 ± 9.9 mm2 at day 1 (p = 0.007) and 6.3 ± 7.0 mm2 vs. 9.2 ± 9.5 mm2 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).ConclusionsSiH 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.