Abstract
Purpose: :
To evaluate the efficacy and tolerability of overnight bandage soft contact lenses applied immediately following laser in–situ Keratomileusis.
Methods: :
Soft Bandage contact lenses (UNO 73, Lensita, Bruxelles, Belgium) were applied immediately following bilateral simultaneous laser in situ keratomieleusis in 161 consecutive patients. Signs and symptoms associated with contact lens wear were prospectively recorded at one hour, 4 hours and on the next morning (12–18 hours following the procedure), using a standardized questionnaire. These included burning, discomfort, pain, tearing, foreign body sensation, secretion and corneal edema. Each sign or symptom was graded on a scale of 0 to 3, and a total score was calculated for each time point. Contact lenses were removed at one hour when the total score was greater than 6. If no signs of contact lens intolerance appeared at one hour, it was removed on the following morning. Multivariate analysis and Fisher's exact test were used for statistical analysis
Results: :
The most common complaints one hour after the procedure were burning sensation (57.1%) followed by discomfort (44.7%) and tearing (31.6%). One hour after the procedure, contact lenses were removed from 43 (26.7%) right eyes and from 29 (18.0%) left eyes because of burning, pain and tearing that were graded 2 or more by the patients. In these patients contact lens removal was associated with a significant decrease of the total score on the next morning (0.59 ± 1.08) compared to one hour (10.89 ± 3.69, p<0.0001). A similar decrease of the total score was noted in those who tolerated the contact lens (2.60 ± 3.57 at one hour compared to 0.41 ± 1.04 on the next morning, p<0.0001). No differences in total scores were observed on the next morning between those who tolerated the contact lenses and those who did not (p=0.3). However in the overnight contact lens users there was more flap edema (p=0.0403).
Conclusions: :
Bandage contact lens application after LASIK is associated with significant reduction of symptoms during the immediate post–operative period. Removal of these contact lenses may be necessary shortly after the procedure in more than a quarter of patient population following LASIK because of symptoms of contact lens intolerance. There is more flap edema in the lens users. These signs should be recognized by the surgeon, to allow prompt removal of the lens.
Keywords: contact lens • refractive surgery: LASIK