Comparison of 3 silicone hydrogel bandage soft contact lenses for pain control after photorefractive keratectomy

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, Lack land 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.