Subject(s)
COVID-19 , Military Personnel , Ophthalmology , Refractive Surgical Procedures , COVID-19/epidemiology , Humans , PandemicsABSTRACT
PURPOSE: To evaluate the safety and efficacy of an experimental dexamethasone-eluting contact lens (DCL) for the prevention of postphotorefractive keratectomy (PRK) corneal haze in a New Zealand White (NZW) rabbit model. METHODS: Both eyes of 29 NZW rabbits underwent PRK. The rabbits were randomized to one of the 5 study arms for 4 weeks: tarsorrhaphy only, tarsorrhaphy and bandage contact lens (BCL) replaced weekly, tarsorrhaphy and BCL for 1 week plus topical 0.1% dexamethasone ophthalmic solution (drops) for 4 weeks, tarsorrhaphy and BCL replaced weekly plus topical dexamethasone for 4 weeks, and tarsorrhaphy and DCL changed weekly for 4 weeks. Each week for 4 consecutive weeks postoperatively, the tarsorrhaphies were opened, the eyes underwent evaluation and imaging, and the tarsorrhaphies were replaced. Contact lenses were cultured on removal. Central corneal haze was assessed weekly with corneal densitometry. After 4 weeks, the animals were killed, and the eyes were enucleated for histopathologic analysis. RESULTS: The tarsorrhaphy only group displayed more haze with a greater change in optical densitometry from pre-op compared with the other treatment groups. There was no difference between the DCL group and the groups receiving a BCL and dexamethasone drops in densitometry or histopathology. No NZW rabbits developed clinical signs of infection, and cultures from DCLs and BCLs grew similar organisms. CONCLUSIONS: In the post-PRK rabbit model, DCLs worn weekly for 4 weeks were safe and as effective at preventing corneal haze as 0.1% dexamethasone drops applied 4 times a day for 4 weeks.
Subject(s)
Cicatrix/prevention & control , Contact Lenses , Corneal Diseases/prevention & control , Dexamethasone/administration & dosage , Disease Models, Animal , Drug Carriers , Glucocorticoids/administration & dosage , Photorefractive Keratectomy/adverse effects , Postoperative Complications , Animals , Cicatrix/etiology , Corneal Diseases/etiology , Female , Lasers, Excimer , Ophthalmic Solutions , RabbitsABSTRACT
OBJECTIVE: To evaluate the relative pain and the relative amount of contact lens loss experienced using two different base curvatures (BCs) of the Acuvue Oasys bandage soft contact lens (BSCL) after photorefractive keratectomy (PRK). METHODS: One hundred forty patients undergoing PRK on either the Allegretto or the VISX laser at the Joint Warfighter Refractive Surgery Center in Lackland AFB, TX, were randomized to one of the two different BCs of the Acuvue Oasys BSCL: 8.4 or 8.8 mm. Patients were evaluated on postoperative days 1 and 4 during which they completed a survey rating absolute pain in each eye on a visual analog pain scale. Lens loss was recorded throughout the study. RESULTS: Patients treated on the Allegretto laser preferred the 8.4-mm BC lens, whereas comfort after treatment on the VISX depended on corneal shape. For VISX, patients with very flat corneas (steep K ≤42 preoperative or ≤38 postoperatively) preferred an 8.8-mm BC lens while patients with very steep corneas (steep K >45 preoperative or >42 postoperative) preferred an 8.4-mm BC lens, though these results were largely not statistically significant. Patients who lost their lenses prematurely tended to be those whose corneal curvature did not match their contact lens BC. CONCLUSIONS: Individuals treated with the Allegretto laser or individuals with more prolate corneas should likely be fit with an 8.4-mm BC Acuvue Oasys BSCL while individuals with more oblate corneas should likely be fit with an 8.8-mm BC lens to minimize postoperative pain and premature BSCL loss.
Subject(s)
Bandages, Hydrocolloid , Contact Lenses, Hydrophilic , Eye Pain/therapy , Photorefractive Keratectomy/adverse effects , Adult , Female , Humans , Hydrogels/therapeutic use , Male , Patient Satisfaction , Regression Analysis , Silicone Elastomers/therapeutic use , Young AdultABSTRACT
PURPOSE: To evaluate the relative pain with 3 U.S. Food and Drug Administration-approved bandage soft contact lenses (SCLs) applied after photorefractive keratectomy (PRK). SETTING: Joint Warfighter Refractive Surgery Center, Lackland Air Force Base, Texas, USA. DESIGN: Prospective comparative case series. METHODS: Patients having PRK were randomized to a senofilcon A (Acuvue Oasys), balafilcon A (Purevision), or lotrafilcon A (Air Optix) bandage SCL in each eye postoperatively. Patients were evaluated 1 and 4 days postoperatively and completed a survey rating absolute pain in each eye on a visual analog scale. RESULTS: The study enrolled 54 patients. At 1 and 4 days, eyes with the senofilcon A lens had the lowest pain scores followed by eyes with the lotrafilcon A lens and then eyes with the balafilcon A lens. Averaging qualitative results from 1 and 4 days showed that eyes with the senofilcon A lens were reported as having more pain by 4% of patients, eyes with the lotrafilcon A lens by 27%, and eyes with the balafilcon A lens by 53%; 16% reported no difference (P<.001). Quantitatively, the senofilcon A lens was 40% more comfortable than the lotrafilcon A lens and 65% more comfortable than the balafilcon A lens on average. The lotrafilcon A lens was 38% more comfortable than the balafilcon A lens on average (P<.01). CONCLUSIONS: There was a statistically and clinically significant difference in post-PRK pain between the 3 bandage SCLs. The senofilcon A lens caused the least pain. FINANCIAL DISCLOSURE: Dr. Reilly is a consultant to Alcon Laboratories, Inc. and Abbott Medical Optics, Inc. but was not at the time of the study. No other author has a financial or proprietary interest in any material or method mentioned.
