Prospective, randomized, eye-to-eye comparison of a new silicone corneal shield versus conventional bandage contact lens after photorefractive keratectomy

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. (C) 2019 ASCRS and ESCRS.