Abstract
Purpose To examine the immediate use of bandage contact lenses (BCLs) for improving patient comfort after small incision lenticule extraction (SMILE) surgery. Methods This is a prospective randomized controlled study in which one hundred and seventy-eight patients undergoing SMILE were randomly allocated to three groups: group A wore BCLs for 8 hours postsurgery, group B wore BCLs for 24 hours postsurgery, and group C did not wear any BCLs postsurgery. Eight subjective symptoms including photophobia, tearing, pain, foreign body sensation, burning, blurred vision, sting, and dry eyes were prospectively evaluated at 2 hours, 4 hours, 8 hours, and 24 hours, using a questionnaire with a total score of 24. The scores of symptoms and signs were compared between the three groups. Results There was a statistically significant time effect on scoring, which implicated a decline in symptoms over time after surgery (P < 0.001). There was also a significant interaction between time and the treatment group (P < 0.01). The total symptom score of groups A and B (5.85 ± 3.97 and 5.99 ± 4.67, respectively) was significantly lower than that of group C at 2 hours postsurgery (7.35 ± 4.86, P < 0.05), especially in tearing and pain (P < 0.05). The level of corneal oedema at 24 hours postsurgery was also statistically significantly different between the three groups (P < 0.001), and the post hoc test showed that groups A and B were lower than group C (P < 0.01). Conclusion Silicon hydrogel BCLs applied immediately after SMILE surgery can relieve postsurgical symptoms of tearing and pain, improving overall patient comfort, and reduce corneal oedema. This trial is registered with ChiCTR-ONRC-13003114. Precis. The application of silicone hydrogel bandage contact lenses immediately after SMILE surgery has the potential to improve patient comfort, corneal healing, and patient satisfaction following SMILE.
Highlights
Refractive surgery has seen continual improvement over the last few decades, with a number of new procedures being performed worldwide
We identified no literature reporting on the clinical application of Silicone hydrogel (SiH) Bandage contact lenses (BCLs) after small incision lenticule extraction (SMILE) surgery so far
E results of this study showed that the main subjective symptoms after SMILE surgery were blurred vision, photophobia, tearing, and foreign body sensation. e symptom scores were highest at 2 hours postsurgery, which gradually reduced over time. is reduction in symptom scores over time reflects what is already known and expected and is similar to the findings reported by previous studies investigating other types of corneal refractive surgery
Summary
Refractive surgery has seen continual improvement over the last few decades, with a number of new procedures being performed worldwide. Advances in technology have made refractive surgeries less invasive, more predictable, and capable of achieving better visual outcomes and less patient discomfort. Despite its advantages, quite a few number of patients complain of ocular discomfort after surgery, including tearing, difficulty with eye opening, and so on. Improved methods for reducing the stimulative symptoms associated with SMILE require continuous exploration. Bandage contact lenses (BCLs) are often used to promote corneal wound healing and reduce patient discomfort after laser refractive surgery [4,5,6], following procedures such as photorefractive keratectomy (PRK) and laser epithelial keratomileusis (LASEK). Conventional hydrogel BCLs had low oxygen transmissibility, which might potentially cause hypoxic
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