Bandage Contact Lenses Improve Clinical Symptoms and Quality of Life After Small Incision Lenticule Extraction: A Retrospective Cohort Study

  Objective  To explore the effect of wearing bandage contact lenses(BCL) on the clinical symptoms and quality of life of patients after small incision lenticule extraction (SMILE).

  Methods  Patients with myopic or myopic astigmatism who underwent SMILE in Peking Union Medical College Hospital from Januaryto May 2019 were collected. According to the postoperative treatment methods, they were divided into the study group and the control group. The study group wore BCL immediately after SMILE, while the control group wore transparent eye patches routinely. BLC or the transparent eye patch was removed on the first day after surgery. The severity and duration of postoperative pain, photophobia, tearing, blurred vision and other clinical symptoms, the impact of pain on quality of life, postoperative uncorrected visual acuity, non-contact intraocular pressure, spherical equivalent, overall surgical satisfaction were compared between the two groups. Meanwhile, BCL adverse reactions was recorded.

  Results  Severity scores of pain 0.2(0, 1.1) vs. 1.1(0.5, 2.1), P=0.007 and photophobia 1.0(0, 2.0) vs. 2.0(0.8, 2.3), P=0.032 as well as the duration of pain 0(0, 1.0) h vs. 2.0(0, 6.3) h, P=0.014 and photophobia 0(0, 1.0) h vs. 2.0(0, 4.3) h, P=0.006 at 24 h after surgery were significantly lower in the study group than those in the control group. There were no significant differences in the severity scores and duration of tears and blurred vision at 24 h postoperatively between the two groups(all P > 0.05). At 24 h after SMILE, the effects of pain on activity, sleep and the relationship with others were lower in the study group than those in the control group(all P < 0.05). At 7 d postoperatively, the score of overall satisfaction to the surgery of the study group was not significantly different from that of the control group10.0(9.0, 10.0) vs. 10.0(9.0, 10.0), P=0.617. There were no significant differences in postoperative uncorrected visual acuity, non-contact intraocular pressure, and spherical equivalent on days 1, 2, and 7 days after SMILE between the two groups (all P > 0.05). BCL related adverse effects (bulbar conjunctival hyperemia) occurred in two patients. The symptoms gradually improved after BCL removal, and the postoperative uncorrected visual acuity recovered to the best-corrected preoperative visual acuity at 7 d after surgery.

  Conclusions  The application of BCL after SMILE can reduce the degree and duration of postoperative pain and photophobia, and improve the postoperative quality of life to a certain extent.