Corneal crosslinking (CXL) is still in its youth as a treatment for keratonconus and other conditions, at least in the US. Although minimal, the procedure is still invasive and requires postoperative care and pain management. Researchers recently published an article in the Journal of Cataract & Refractive Surgery showing that wound healing appeared quicker when clinicians use an occlusive patch rather than the more traditional application of bandage contact lenses.
The authors looked at 60 eyes of 52 patients who had undergone epithelial-off CXL. They divided their subjects into three groups based on three postoperative approaches: (1) traditional bandage contact lenses, (2) occlusive patches and (3) an antibiotic ointment. The investigators used the McGill Pain Questionnaire and Visual Analogue Score (VAS) to track the patients’ progress.
They found that patients experienced considerable pain after CXL with a median VAS of 6.2 (out of 10). The postoperative regimen did not significantly affect pain scores—though the antibiotic ointment group reported a higher VAS than the others. But the occlusive patching group did heal significantly quicker than the other two groups. On follow up, 85% of occluded patients were completely healed as opposed to 70% of patients who were given antibiotic ointment and only 65% of bandage contact lens patients.
In light of these results, the authors advocate re-evaluating the clinical tradition of using bandage contact lenses after CXL.
|Soeters N, Hendriks I, Godefrooij D, et al. A prospective three-armed study on pain and epithelial healing after corneal crosslinking. J Cat Refract Surg. August 22, 2019. [Epub ahead of print].|