The protective effect of bandage contact lens on the cornea of diabetic patients during vitreoretinal surgery

Abstract

Objective To observe the effect of bandage contact lens on epithelial after vitreoretinal surgery for proliferative diabetic retinopathy. Methods In this prospective, randomized, comparative clinical study, 60 eyes of 56 patients with PDR were randomly divided into two groups. They underwent vitreoretinal surgery. Group A, 29 eyes of 29 cases, the bandage contact lens were covered on corneal surface during surgery under noncontact wide-angle viewing systems. Group B, 31 eyes of 27 cases, the hydroxypropyl methylcellulose were covered on corneal surface during the same surgery. The corneal fluorescein sodium staining, tear function, count of corneal endothelium cells before and after operation were assessed. Results Pre-operation, corneal fluorescein staining positive rate was 41.38% in group A and 41.94% in group B (χ2=0.002, P=0.965). At 1, 2 and 3 d after surgery, the positive rate of group A was 44.83%, 41.37% and 37.93%, in group B was 70.97%, 70.97% and 67.74%, (χ2=4.212, 5.342, 5.350; all P<0.05). At 7 d after surgery, the positive rate was 41.37% in group A and 61.29% in group B (χ2=2.379, P=0.123). The BUT was (6.69±2.02)s in group A and (7.09±1.98)s in group B before surgery (t=-0.913, P=0.327). At 1, 2 and 3 d after surgery, the BUT of group A was (5.77±3.10)s, (5.91±2.64)s and (6.08±2.57)s, in group B was (4.49±3.42)s, (4.76±2.55)s and (5.18±2.31)s (t=3.279, 3.011, 2.259; all P<0.05). At 7 d after surgery, BUT was (6.28±2.41)s in group A and (5.67±2.51)s in group B (t=1.983, P=0.076). The difference of SchirmerⅠtest was not significant between two groups. Conclusion Bandage contact lens are used in vitreoretinal surgery for diabetic patients. Bandage contact lens superior to hydroxypropyl methylcellulose in the early postoperative corneal epithelial integrity and tear film stability. The bandage contact lens could protect the corneal epithelium during vitreoretinal surgery. Key words: Surgery, vitreoretinal; Retinopathy, diabetic, proliferative; Contact lens, bandage; Cornea; Wide-angle viewing, noncontact