An evaluation of the therapeutic effect of the bandage contact lenses after pterygium surgery using ultra-high resolution optical coherence tomography

Abstract

Objective To evaluate the therapeutic effect of the bandage contact lens (BCL) using ultra-high resolution optical coherence tomography (UHR-OCT) after pterygium surgery.Methods Prospective case-control study.Sixty eyes of 60 patients undergoing pterygium excision and conjunctival autografting were randomly allocated into 2 groups:30 eyes were covered with silicone hydrogel BCLs at the conclusion of surgery and 30 eyes served as a control.UHR-OCT scans of the cornea were performed sequentially on day 1,day 2,day 3,and then every other day until the end of re-epithelialization after surgery.Complete corneal epithelial healing was verified with fluorescein staining after removal of the BCLs.Post-surgical pain was evaluated using the visual analogue scale (VAS).An independent t test and a Mann-Whitney U test were used.Results All BCLs were successfully fit without any contact lens-related complications.UHR-OCT images clearly revealed the architectural features of the postoperative cornea with BCL in situ and showed the epithelial healing process.UHR-OCT imaging highly agreed with the fluorescein staining in detecting corneal epithelial defects (95％).Based on the assessment by UHR-OCT,the average time line for re-epithelialization in the BCL group was 3.7±1.2 days while in the control group it was 4.8±1.5 days (t=16.78,P＜0.01).VAS scores reported lower pain levels in the BCL group compared to the control group at each time point (Z=-4.75,-3.84,-2.96,-2.52,-1.98,all P＜0.05).Conclusion Silicone hydrogel BCL is recommended as an adjuvant therapy after pterygium surgery for its efficacy in improving re-epithelialization and postoperative comfort.UHR-OCT is an excellent tool in monitoring corneal epithelial healing under BCLs and determining the appropriate time for lens removal. Key words: Pterygium; Contact lenses,hydrophilic ; Optical coherence,tomography ; Cornea