Monitor Corneal Epithelial Healing Under Bandage Contact Lens Using Ultrahigh-Resolution Optical Coherence Tomography After Pterygium Surgery

Objective: To monitor corneal epithelial healing under bandage contact lens (BCL) using ultrahigh-resolution optical coherence tomography (UHR-OCT) after pterygium surgery. Methods: Thirty-nine eyes of 39 patients undergoing pterygium excision and conjunctival autografting were randomly allocated into 2 groups: 20 eyes were covered with silicone hydrogel BCLs at the end of surgery and 19 eyes served as a control. Ultrahigh-resolution optical coherence tomography scans of the cornea were performed sequentially at 1, 2, and 3 days, and then every other day until the end of re-epithelialization after surgery. Complete epithelial healing was verified with fluorescein staining examination after removal of BCLs. Postsurgery pain was evaluated using the visual analog scale. Results: All BCLs were successfully fit without any contact lens-related complications. Ultrahigh-resolution optical coherence images clearly revealed the architectural features of postoperative cornea with BCL in situ and showed epithelial healing process. Ultrahigh-resolution optical coherence tomography imaging agreed with the fluorescein staining examinations in detecting corneal epithelial defect. Based on the assessment by UHR-OCT, the average time course of re-epithelialization in the BCL group was 3.9 +/- 1.2 days, whereas in the control group, it was 5.7 +/- 1.8 days (P=0.001). Visual analog scale scoring showed lower pain levels in the BCL group comparing with the control group at each point of time (all P<0.05). Conclusions: Ultrahigh-resolution optical coherence tomography is an excellent tool in monitoring corneal epithelial healing under BCLs and determining the appropriate time for lens removal. Silicone hydrogel BCL is recommended as an adjuvant therapy after pterygium surgery for its efficacy in improving re-epithelialization and postoperative comfort.