Purpose

To compare uncorrected distance visual acuity (UDVA) and patient-reported outcomes with a new silicone corneal shield and a conventional bandage contact lens (BCL) after photorefractive keratectomy (PRK).

Setting

Stanford Eye Laser Center (Palo Alto, California) and Slade & Baker Vision (Houston, Texas).

Design

Prospective randomized cohort study.

Methods

Standardized bilateral wavefront-guided or wavefront-optimized PRK was performed in 25 patients with myopia. Each patient's dominant eye was randomized to either a silicone corneal shield or a conventional BCL, which was placed at the conclusion of surgery. The contralateral eye was assigned the other intervention. The UDVA and patient-reported outcomes were measured preoperatively, 1 hour after surgery, and at 1, 2, 3, 4, and 7 days postoperatively.

Results

At 1 day postoperatively, the mean logarithm of the minimum angle of resolution (logMAR) UDVA was 0.04 ± 0.16 (SD) in the silicone corneal shield group and 0.29 ± 0.22 in the BCL group (P < 0.01). At 7 days postoperatively, the mean logMAR UDVA was 0.09 ± 0.17 in the silicone corneal shield group and 0.23 ± 0.24 in the BCL group (P = .01). At 1 day through 3 days postoperatively, the patients reported greater pain, discomfort, foreign body sensation, and heavy eyelid in the eye with the silicone corneal shield. There was no statistically significant difference in the survey outcomes between the two groups at 4 days and 7 days postoperatively.

Conclusions

The new silicone corneal shield was safe and effective, with faster visual recovery and a trend toward quicker epithelialization; however, it might be less comfortable than a conventional BCL.

中文翻译：

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角膜切除术后新型硅胶角膜防护罩与传统绷带隐形眼镜的随机，前瞻性比较

目的

为了比较未矫正的远距离视力（UDVA）和患者报告的结果，使用新的硅胶角膜防护罩和传统的绷带隐形眼镜（BCL）进行屈光性角膜切除术（PRK）后。

设置

斯坦福大学眼睛激光中心（加利福尼亚州帕洛阿尔托）和斯莱德和贝克视觉公司（德克萨斯州休斯顿）。

设计

前瞻性随机队列研究。

方法

对25名近视患者进行了标准化的双边波前引导或波前优化PRK。每位患者的优势眼被随机分配至硅胶角膜防护罩或常规BCL，并在手术结束时放置。对侧眼被指定其他干预措施。术前，术后1小时以及术后1、2、3、4和7天测量UDVA和患者报告的结局。

结果

术后1天，硅胶角膜防护组的最小分辨角（logMAR）UDVA的平均对数为0.04±0.16（SD），而BCL组为0.29±0.22（P  <0.01）。术后7天，硅胶角膜防护组的平均logMAR UDVA为0.09±0.17，而BCL组的平均logMAR UDVA为0.23±0.24（P  = .01）。术后1天到3天，使用硅胶角膜防护罩的患者报告疼痛，不适，异物感和眼睑沉重。两组在术后4天和7天的调查结果之间无统计学差异。

结论

新型硅酮角膜防护罩安全有效，具有更快的视觉恢复能力和趋于更快上皮形成的趋势。但是，它可能不如常规BCL舒适。