Comparison Between Bandage Contact Lenses and Pressure Patching on the Erosion Area and Pain Scale in Patients With Corneal Erosion

Triharpini, Ni Nyoman; Jayanegara, I Wayan Gede; Handayani, Ariesanti Tri; Widiana, I Gde Raka

doi:10.1097/apo.0000000000000010

Cited by 9 publications

(8 citation statements)

References 13 publications

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“…In addition to studies that compared an intervention to a control group, seven studies ( n = 591) included comparisons of two interventions. Four studies compared patching to BCL 13,16,52,54 . Meta‐analysis found no significant difference in epithelial healing at 24 hours (RR = 1.18, 95% CI = 0.75 to 1.84; low certainty of evidence; Figure a).…”

Section: Resultsmentioning

confidence: 98%

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Topical pain control for corneal abrasions: A systematic review and meta‐analysis

Kirubarajan

Yau

et al. 2021

Academic Emergency Medicine

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Objectives Corneal abrasions are common ophthalmic presentations to emergency departments. Among emergency physicians and ophthalmologists, there are highly variable practice patterns with regard to management of resultant pain and discomfort. The goal of this study was to review and analyze the efficacy and safety of topical pain therapies for corneal abrasions, including topical anesthetics, nonsteroidal anti‐inflammatory drugs (NSAIDs), cycloplegics, steroids, pressure patching, and the use of a bandage contact lens (BCL). Methods The review followed the Preferred Reporting Items for Systematic Review and Meta‐analysis (PRISMA) guidelines. The protocol was established a priori and published on PROSPERO (CRD42020201288). MEDLINE, EMBASE, CENTRAL, and Web of Science were searched until December 31, 2020. Primary studies comparing topical pain therapies to another therapy or control were included. Primary outcomes included percentage of corneal abrasions healed at 24, 48, and 72 hours, as well as pain control at 24 and 48 hours. Secondary outcomes included use of oral analgesia and incidence of complications. Risk of bias was assessed using validated tools. Quality of evidence was assessed using the GRADE methodology. Results Overall, 33 studies (31 randomized controlled trials [RCTs], two cohort studies) comprising 4,167 patients with corneal abrasions were analyzed. Only the data for topical NSAIDs were of adequate evidence from which to draw conclusions; topical NSAIDs demonstrated significantly reduced pain scores at 24 hours (standardized mean differences [SMD] –0.69, 95% CI = –0.98 to –0.41) and 48 hours (SMD = –0.56, 95% CI = –1.02 to –0.10) as well as 53% (95% CI = 34% to 67%) lower oral analgesia use compared to control. Based on available data, topical anesthetics, cycloplegics, patching, and the use of a BCL did not result in any significant difference in pain scores or use of oral analgesia, while no studies examined topical steroids. No interventions resulted in healing delays or significantly higher rates of complications compared to controls. Conclusions There was strong evidence to support that topical NSAIDs reduce pain associated with corneal abrasions in the first 48 hours and the need for oral analgesia. The existing evidence was insufficient to support or refute the use of topical anesthetics, cycloplegics, steroids, or BCL for pain control in corneal abrasions. Pressure patching was ineffective at pain reduction and may increase the risk of complications. Delays in healing or other complications were not significantly different between any intervention or control for simple, uncomplicated corneal abrasions; however, larger RCTs are required to identify any differences in rare complications.

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Section: Resultsmentioning

confidence: 98%

“…The same study found that receiving a BCL did not change the use of oral analgesia use. In three studies ( n = 117) reporting on BCL use, no complications were reported 13,16,52 …”

Section: Resultsmentioning

confidence: 99%

Topical pain control for corneal abrasions: A systematic review and meta‐analysis

Kirubarajan

Yau

et al. 2021

Academic Emergency Medicine

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“…Studies have found that bandage contact lenses (BCLs) are effective in reducing pain from traumatic abrasions with the added advantage of maintaining vision during treatment [ 113 , 114 ]. BCLs may be used alone or in conjunction with AM placement to facilitate wound healing.…”

Section: Mechanical Barrier Therapiesmentioning

confidence: 99%

Treatment of Non-Infectious Corneal Injury: Review of Diagnostic Agents, Therapeutic Medications, and Future Targets

Dang

Riaz

Karamichos

2022

Drugs

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Corneal injuries can occur secondary to traumatic, chemical, inflammatory, metabolic, autoimmune, and iatrogenic causes. Ocular infection may frequently occur concurrent to corneal injury; however, antimicrobial agents are excluded from this present review. While practitioners may primarily rely on clinical examination techniques to assess these injuries, several pharmacological agents, such as fluorescein, lissamine green, and rose bengal, can be used to formulate a diagnosis and develop effective treatment strategies. Practitioners may choose from several analgesic medications to help with patient comfort without risking further injury or delaying ocular healing. Atropine, cyclopentolate, scopolamine, and homatropine are among the most frequently used medications for this purpose. Additional topical analgesic agents may be used judiciously to augment patient comfort to facilitate diagnosis. Steroidal anti-inflammatory agents are frequently used as part of the therapeutic regimen. A variety of commonly used agents, including prednisolone acetate, loteprednol, difluprednate, dexamethasone, fluorometholone, and methylprednisolone are discussed. While these medications are effective for controlling ocular inflammation, side effects, such as elevated intraocular pressure and cataract formation, must be monitored by clinicians. Non-steroidal medications, such as ketorolac, bromfenac, nepafenac, and diclofenac, are additionally used for their efficacy in controlling ocular inflammation without incurring side effects seen with steroids. However, these agents have their own respective side effects, warranting close monitoring by clinicians. Additionally, ophthalmologists routinely employ several agents in an off-label manner for supplementary control of inflammation and treatment of corneal injuries. Patients with corneal injuries not infrequently have significant ocular surface disease, either as a concurrent pathology or as an exacerbation of previously existing disease. Several agents used in the management of ocular surface disease have also been found to be useful as part of the therapeutic armamentarium for treatment of corneal injuries. For example, several antibiotics, such as doxycycline and macrolides, have been used for their anti-inflammatory effects on specific cytokines that are upregulated during acute injuries. There has been a recent wave of interest in amniotic membrane therapies (AMTs), including topical, cryopreserved and dehydrated variants. AMT is particularly effective in ocular injuries with violation of corneal surface integrity due to its ability to promote reepithelialization of the corneal epithelium. Blood-based therapies, including autologous serum tears, plasma-enriched growth factor eyedrops and autologous blood drops, have additionally been explored in small case series for effectiveness in challenging and recalcitrant cases. Protection of the ocular surface is also a vital component in the treatment of corneal injuries. Temporary protective methods, such as bandage contact lenses and me...

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“…A later report on the efficacy of the same silicone hydrogel BSCL compared to patching for the treatment of traumatic erosions showed that patients wearing BSCL had less pain than those that were patched [164]. The authors point out that the pressure patch had to be removed for the instillation of topical medications and was replaced at home by family members or the patient.…”

Section: Corneal Abrasions and Recurrent Corneal Erosion Syndrome (Rces)mentioning

confidence: 99%

BCLA CLEAR – Medical use of contact lenses

Jacobs

Carrasquillo²,

Cottrell

et al. 2021

Contact Lens and Anterior Eye

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The medical use of contact lenses is a solution for many complex ocular conditions, including high refractive error, irregular astigmatism, primary and secondary corneal ectasia, disfiguring disease, and ocular surface disease. The development of highly oxygen permeable soft and rigid materials has extended the suitability of contact lenses for such applications. There is consistent evidence that bandage soft contact lenses, particularly silicone hydrogel lenses, improve epithelial healing and reduce pain in persistent epithelial defects, after trauma or surgery, and in corneal dystrophies. Drug delivery applications of contact lens hold promise for improving topical therapy. Modern scleral lens practice has achieved great success for both visual rehabilitation and therapeutic applications, including those requiring retention of a tear reservoir or protection from an adverse environment. This report offers a practical and relevant summary of the current evidence for the medical use of contact lenses for all eye care professionals including optometrists, ophthalmologists, opticians, and orthoptists. Topics covered include indications for use in both acute and chronic conditions, lens selection, patient selection, wear and care regimens, and recommended aftercare schedules. Prevention, presentation, and management of complications of medical use are reviewed.

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Comparison Between Bandage Contact Lenses and Pressure Patching on the Erosion Area and Pain Scale in Patients With Corneal Erosion

Abstract: Bandage contact lenses are an effective alternative to treating mechanical corneal erosion because of their effect in reducing pain without causing any complications.

Cited by 9 publications

References 13 publications

Topical pain control for corneal abrasions: A systematic review and meta‐analysis

Topical pain control for corneal abrasions: A systematic review and meta‐analysis

Treatment of Non-Infectious Corneal Injury: Review of Diagnostic Agents, Therapeutic Medications, and Future Targets

BCLA CLEAR – Medical use of contact lenses

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