Bandage Contact Lens and Topical Indomethacin for Treating Persistent Corneal Epithelial Defects After Vitreoretinal Surgery

Abstract

Persistent corneal epithelial defect is a complication of vitreoretinal surgery. We assessed the efficacy of using bandage contact lenses in conjunction with topical indomethacin to facilitate wound healing and control pain safely. Patients presenting with a persistent corneal epithelial defect after vitreoretinal surgery were assigned randomly to 1 of 2 treatment groups. Patients in both groups received a therapeutic contact lens and chloramphenicol eyedrops, whereas group A received indomethacin eyedrops and group B received placebo eyedrops. This study was conducted in a single-masked randomized fashion. Patients were evaluated daily to monitor subjective symptoms and to measure the maximum and minimum dimensions of the epithelial defects. Sixteen patients were analyzed. The subjective evaluation of photophobia, foreign-body sensation, and tearing on the day after starting treatment did not differ significantly between the 2 groups (P > 0.05), whereas the difference in the mean pain decrease between groups A and B at day 1 was significant (P = 0.01). The rate of epithelial healing quantified as the days needed to heal the epithelial defect did not differ between the 2 groups (P = 0.823). Our study showed that topical indomethacin ophthalmic solution improves comfort in patients with a persistent corneal epithelial defect (after vitreoretinal surgery) treated with bandage contact lenses.