Masked comparison of silicone hydrogel lotrafilcon A and etafilcon A extended-wear bandage contact lenses after photorefractive keratectomy.
OBJECTIVE
To compare the efficacy of 2 types of bandage contact lenses (BCLs) after photorefractive keratectomy (PRK).


METHODS
Navy Refractive Surgery Center, Naval Medical Center San Diego, San Diego, California, USA.


METHODS
In this prospective study, 100 patients received PRK in both eyes. Each patient received a BCL composed of etafilcon A (Acuvue [ACV], Vistakon Inc.) (14.0 diameter, 8.4/8.8 base curve) in 1 eye and lotrafilcon A (Focus Night & Day [N&D], Ciba Vision) (13.8 diameter, 8.4/8.6 base curve) in the fellow eye. The patient was masked to the lens type in each eye. The postoperative medication regimen was the same with both lenses. The epithelial defect size and subjective level of discomfort were measured at surgery and daily after surgery until both eyes had reepithelialized and the lenses were removed.


RESULTS
The mean epithelial defect size at surgery was similar with both BCLs (ACV 57.07 mm(2) and N&D 57.53 mm(2); P=.422). On postoperative days 1 and 2, the mean defect size was significantly smaller in eyes with the N&D lens (day 1, ACV 21.53 and N&D 18.74; day 2, ACV 3.62 and N&D 2.12) (paired t test, P<.001). On day 1, no eye had completely reepithelialized; on day 2, 20 eyes with N&D lenses and 13 eyes with ACV lenses had. On day 3, 70 eyes with N&D lenses and 66 eyes with ACV lenses had reepithelialized. The mean discomfort index was significantly higher in the eyes with ACV lenses on days 1 and 2 (paired t test, P<.001 and P<.002, respectively). Topical nonpreserved tetracaine was used significantly more often in eyes with ACV lenses on days 1, 2, and 3 (paired t test, P<.001, P<.008, P<.003, respectively). No correlation between the use of tetracaine in the first 24 hours and the rate of reepithelialization was noted (R(2)=0.0025 for ACV and R(2)=0.0003 for N&D).


CONCLUSIONS
The lotrafilcon A lens resulted in significantly faster corneal reepithelialization and reduced patient discomfort in most patients during the first 48 hours after PRK.
Engle
Andrew T
AT
Department of Ophthalmology, Naval Medical Center San Diego, San Diego, California 92134-1005, USA. aengle@aol.com
Laurent
John M
JM
Schallhorn
Steven C
SC
Toman
Steven D
SD
Newacheck
James S
JS
Tanzer
David J
DJ
Tidwell
James L
JL
D000293:Adolescent; D000328:Adult; D001458:Bandages; D003262:Contact Lenses, Extended-Wear; D019573:Epithelium, Corneal / Q000502:physiology*; D006801:Humans; D020100:Hydrogels; D054018:Lasers, Excimer; D008689:Methacrylates; D010147:Pain Measurement; D010149:Postoperative Pain / Q000503:physiopathology; D018903:Photorefractive Keratectomy; D011446:Prospective Studies; D012828:Silicones; D014945:Wound Healing / Q000502:physiology*; D005466:Fluorocarbons
D020100:Hydrogels; D008689:Methacrylates; D012828:Silicones; C114176:etafilcon; C481129:lotrafilcon A; D005466:Fluorocarbons