Efficacy of two silicone-hydrogel contact lenses for bandage use after photorefractive keratectomy

Published:March 21, 2013DOI:



      To evaluate the efficacy of two silicone hydrogel (SiH) contact lenses, approved for continuous wear for one week, following photorefractive keratectomy (PRK).


      Forty seven myopic patients (94 eyes) undergone bilateral PRK were enrolled in this prospective, double-masked, comparative study. One eye of each patient was fitted with a Lotrafilcon B lens (Ciba Vision, Duluth, US; 30-day recommended replacement) whereas the fellow eye was fitted with an Asmofilcon A lens (Menicon, Nagoya, Japan; 14-day recommended replacement). Epithelial defect size was assessed using slit lamp biomicroscopy on the day of surgery and at days 1–4 post-operatively. Uncorrected and best-corrected visual acuity and retinal straylight (C-Quant, Oculus Optigerate, Germany) were evaluated pre-operatively and one month post-operatively.


      Average epithelial defect size for Asmofilcon A and Lotrafilcon B was 25.5 ± 11.0 mm2 vs. 27.1 ± 9.9 mm2 at day 1 (p = 0.007) and 6.3 ± 7.0 mm2 vs. 9.2 ± 9.5 mm2 at day 2 (p = 0.012) post-operatively. Re-epithelialization at day 3 was completed in 87.2% of the eyes fitted with Asmofilcon A lenses, compared to 74.5% with Lotrafilcon B lenses (p = 0.012). At the 3rd post-operative day 29.8% of re-epithelialized eyes showed irregular suture with Lotrafilcon B, compared to 12.8% eyes with Asmofilcon A lenses (p < 0.001). Finally, no statistically significant differences were found post-operatively between the two lenses retinal straylight (p = 0.98) and best-corrected visual acuity (p = 0.68).


      SiH lenses can be used as an effective bandage after PRK due to the limited time requested for achieving complete corneal re-epithelialization. Faster and smoother epithelial healing is provided with Asmofilcon A over Lotrafilcon B lenses.


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        • Krueger R.R.
        • Rabinowitz Y.S.
        • Binder P.S.
        The 25th anniversary of excimer lasers in refractive surgery: historical review.
        Journal of Refractive Surgery. 2010; 26: 749-760
        • Miyai T.
        • Miyata K.
        • Nejima R.
        • Honbo M.
        • Minami K.
        • Amano S.
        Comparison of laser in situ keratomileusis and photorefractive keratectomy results: long-term follow-up.
        Journal of Cataract and Refractive Surgery. 2008; 34: 1527-1531
        • Cherry P.M.
        The treatment of pain following excimer laser photorefractive keratectomy: additive effect of local anesthetic drops, topical diclofenac, and bandage soft contact.
        Ophthalmic Surgery and Lasers. 1996; 27: S477-S480
        • McDonald M.B.
        • Deitz M.R.
        • Frantz J.M.
        • Kraff M.C.
        • Krueger R.R.
        • Salz J.J.
        • et al.
        Photorefractive keratectomy for low-to-moderate myopia and astigmatism with a small-beam, tracker-directed excimer laser.
        Ophthalmology. 1999; 106 (discussion 8-9): 1481-1488
        • Brilakis H.S.
        • Deutsch T.A.
        Topical tetracaine with bandage soft contact lens pain control after photorefractive keratectomy.
        Journal of Refractive Surgery. 2000; 16: 444-447
        • Engle A.T.
        • Laurent J.M.
        • Schallhorn S.C.
        • Toman S.D.
        • Newacheck J.S.
        • Tanzer D.J.
        • et al.
        Masked comparison of silicone hydrogel lotrafilcon A and etafilcon A extended-wear bandage contact lenses after photorefractive keratectomy.
        Journal of Cataract and Refractive Surgery. 2005; 31: 681-686
        • Edwards J.D.
        • Bower K.S.
        • Sediq D.A.
        • Burka J.M.
        • Stutzman R.D.
        • Vanroekel C.R.
        • et al.
        Effects of lotrafilcon A and omafilcon A bandage contact lenses on visual outcomes after photorefractive keratectomy.
        Journal of Cataract and Refractive Surgery. 2008; 34: 1288-1294
        • Gil-Cazorla R.
        • Teus M.A.
        • Arranz-Marquez E.
        Comparison of silicone and non-silicone hydrogel soft contact lenses used as a bandage after LASEK.
        Journal of Refractive Surgery. 2008; 24: 199-203
        • Gil-Cazorla R.
        • Teus M.A.
        • Hernandez-Verdejo J.L.
        • De Benito-Llopis L.
        • Garcia-Gonzalez M.
        Comparative study of two silicone hydrogel contact lenses used as bandage contact lenses after LASEK.
        Optometry and Vision Science. 2008; 85: 884-888
        • Grentzelos M.A.
        • Plainis S.
        • Astyrakakis N.I.
        • Diakonis V.F.
        • Kymionis G.D.
        • Kallinikos P.
        • et al.
        Efficacy of 2 types of silicone hydrogel bandage contact lenses after photorefractive keratectomy.
        Journal of Cataract and Refractive Surgery. 2009; 35: 2103-2108
        • Qu X.M.
        • Dai J.H.
        • Jiang Z.Y.
        • Qian Y.F.
        Clinic study on silicone hydrogel contact lenses used as bandage contact lenses after LASEK surgery.
        International Journal of Ophthalmology. 2011; 4: 314-318
        • Razmjoo H.
        • Abdi E.
        • Atashkadi S.
        • Reza A.M.
        • Reza P.A.
        • Akbari M.
        Comparative study of two silicone hydrogel contact lenses used as bandage contact lenses after photorefractive keratectomy.
        International Journal of Preventive Medicine. 2012; 3: 718-722
        • Szaflik J.P.
        • Ambroziak A.M.
        • Szaflik J.
        Therapeutic use of a lotrafilcon A silicone hydrogel soft contact lens as a bandage after LASEK surgery.
        Eye and Contact Lens. 2004; 30: 59-62
        • Lim-Bon-Siong R.
        • Valluri S.
        • Gordon M.E.
        • Pepose J.S.
        Efficacy and safety of the ProTek (Vifilcon A) therapeutic soft contact lens after photorefractive keratectomy.
        American Journal of Ophthalmology. 1998; 125: 169-176
        • Demers P.
        • Thompson P.
        • Bernier R.G.
        • Lemire J.
        • Laflamme P.
        Effect of occlusive pressure patching on the rate of epithelial wound healing after photorefractive keratectomy.
        Journal of Cataract and Refractive Surgery. 1996; 22: 59-62
        • Blackmore S.J.
        The use of contact lenses in the treatment of persistent epithelial defects.
        Contact Lens and Anterior Eye. 2010; 33: 239-244
        • Khakshoor H.
        • Zarei-Ghanavati M.
        • Saffarian L.
        Mechanical superficial keratectomy for corneal haze after photorefractive keratectomy with mitomycin C and extended wear contact lens.
        Cornea. 2011; 30: 117-120
        • Liu X.
        • Wang P.
        • Kao A.A.
        • Jiang Y.
        • Li Y.
        • Long Q.
        Bacterial contaminants of bandage contact lenses used after laser subepithelial or photorefractive keratectomy.
        Eye and Contact Lens. 2012; 38: 227-230
        • Foulks G.N.
        Prolonging contact lens wear and making contact lens wear safer.
        American Journal of Ophthalmology. 2006; 141: 369-373
        • Arora R.
        • Jain S.
        • Monga S.
        • Narayanan R.
        • Raina U.K.
        • Mehta D.K.
        Efficacy of continuous wear PureVision contact lenses for therapeutic use.
        Contact Lens and Anterior Eye. 2004; 27: 39-43
        • Plainis S.
        • Tzatzala P.
        • Orphanos Y.
        • Tsilimbaris M.K.
        A modified ETDRS visual acuity chart for European-wide use.
        Optometry and Vision Science. 2007; 84: 647-653
        • Franssen L.
        • Coppens J.E.
        • van den Berg T.J.
        Compensation comparison method for assessment of retinal straylight.
        Investigative Ophthalmology and Visual Science. 2006; 47: 768-776
        • Kymionis G.D.
        • Plaka A.
        • Kontadakis G.A.
        • Astyrakakis N.
        Treatment of corneal dellen with a large diameter soft contact lens.
        Contact Lens and Anterior Eye. 2011; 34: 290-292
        • Cavanagh H.D.
        • Ladage P.M.
        • Li S.L.
        • Yamamoto K.
        • Molai M.
        • Ren D.H.
        • et al.
        Effects of daily and overnight wear of a novel hyper oxygen-transmissible soft contact lens on bacterial binding and corneal epithelium: a 13-month clinical trial.
        Ophthalmology. 2002; 109: 1957-1969
        • Ren D.H.
        • Yamamoto K.
        • Ladage P.M.
        • Molai M.
        • Li L.
        • Petroll W.M.
        • et al.
        Adaptive effects of 30-night wear of hyper-O(2) transmissible contact lenses on bacterial binding and corneal epithelium: a 1-year clinical trial.
        Ophthalmology. 2002; 109 (discussion -40): 27-39
        • Leccisotti A.
        Mitomycin C in photorefractive keratectomy: effect on epithelialization and predictability.
        Cornea. 2008; 27: 288-291
        • Kremer I.
        • Ehrenberg M.
        • Levinger S.
        Delayed epithelial healing following photorefractive keratectomy with mitomycin C treatment.
        Acta Ophthalmologica. 2012; 90: 271-276
        • Lakkis C.
        • Vincent S.
        Clinical investigation of asmofilcon a silicone hydrogel lenses.
        Optometry and Vision Science. 2009; 86: 350-356
        • Santodomingo-Rubido J.
        • Wolffsohn J.S.
        • Gilmartin B.
        Changes in ocular physiology, tear film characteristics, and symptomatology with 18 months silicone hydrogel contact lens wear.
        Optometry and Vision Science. 2006; 83: 73-81