Effectiveness of bandage contact lens application in corneal epithelialization and pain alleviation following corneal transplantation; prospective, randomized clinical trial.

Jun Shimazaki,Seika Den,Murat Dogru,Yumiko Saijo-Ban,Chika Shigeyasu

doi:10.1186/s12886-016-0346-6

Jun Shimazaki, Seika Den + Show 3 more

Open Access

https://doi.org/10.1186/s12886-016-0346-6

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Abstract

BackgroundTo assess the efficacy of bandage contact lens (BCL) application to promote epithelialization and alleviate pain following corneal transplantation.MethodsTwenty-six consecutive patients who underwent corneal transplantation were randomly assigned to undergo BCL application (BCL group, n = 14) or no BCL application (control group, n = 12) at the end of the surgery. Corneal epithelialization was analyzed by photography using fluorescein staining, and ocular pain was measured using a visual analog scale.ResultsThe mean size of the epithelial defect relative to the graft area in the BCL group was 21.80 ± 35.10 % at the end of surgery, 18.20 ± 31.10 % on postoperative day 1, and 5.45 ± 11.10 % on postoperative days 3 to 5. These values in the control group were 9.64 ± 17.60 % at the end of surgery, 11.50 ± 25.70 % on postoperative day 1, and 0.00 ± 0.00 % on postoperative days 3 to 5. There were no significant differences in the speed of epithelialization between the two groups. The mean preoperative pain score in the BCL group was slightly higher than that control (4.27 ± 1.96 vs. 2.41 ± 2.18, respectively; P = 0.039). The scores significantly increased on postoperative day 1 and promptly returned to preoperative levels by day 7 in both groups, and there were no significant differences between the groups.ConclusionsNo significant benefits of BCL application at the time of corneal transplantation were observed in this study. The efficacy and safety of BCLs in eyes with compromised epithelialization require further study.Trial registration numberUMIN 000019091. Date of registration: 2015/09/22

Highlights

To assess the efficacy of bandage contact lens (BCL) application to promote epithelialization and alleviate pain following corneal transplantation
Study design In this randomized, prospective, single-center clinical trial, we evaluated consecutive patients undergoing corneal transplantation at Tokyo Dental College Ichikawa General Hospital, a referral hospital for corneal transplantation, from October 2006 to May 2008
In the BCL group, causative diseases included bullous keratopathy (n = 7) including one eye with Fuchs’ dystrophy, regrafting (n = 3), corneal scarring secondary to interstitial keratitis (n = 2), and keratoconus (n = 2)

Summary

Introduction

To assess the efficacy of bandage contact lens (BCL) application to promote epithelialization and alleviate pain following corneal transplantation. Proper postoperative management is a key factor for successful outcomes of corneal transplantation. Prompt epithelialization is essential for avoiding vision-threatening complications such as infection, scarring, and stromal melting [1]. Application of a bandage contact lens (BCL) is one management technique for promoting corneal epithelialization. Shimazaki et al BMC Ophthalmology (2016) 16:174. Despite wide recognition of the usefulness of BCLs for the postoperative management of corneal transplantation, no detailed studies of this technique have been reported. We conducted a prospective randomized study to assess the speed of epithelialization and suppression of postoperative pain associated with BCL application following corneal transplantation

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