Role of bandage contact lens in corneal wound healing

clinical longitudinal study at BP Koirala Lions Center for Ophthalmic Studies

1. Role of Bandage Contact
Lens in
Corneal Wound Healing
Prakash Paudel, Asik Pradhan, Dr. Meenu Chaudhary
TU, Institute of Medicine,
B. P. Koirala Lions Centre for Ophthalmic Studies

2. What is a Contact Lens?
“Contact Lens”
a thin transparent lens
made up of different
materials like PMMA,
HEMA, Silicon-Acrylic
etc.

3. Why contact lenses?
Purposes of Contact
lenses
optical, therapeutic,
prosthesis and
cosmesis.

4. Why contact lenses?
Refractive correction
Keratoconus
Post - PKP
Post - Refractive
Surgery

5. Why contact lenses?
Refractive Errors
treatment
Can MOLD cornea to
decrease myopia
“Orthokeratology” or
Corneal Refractive
Therapy (CRT)

6. Why contact lenses?
Pediatric use
Congenital aphakia
High anisometropia
Amblyopia Tx

Patching alternative
Prosthetic use
To hide blemish
Therapeutic use
(Bandage Contact Lens)

7. Bandage Contact Lens
Hydrophilic in nature with high water
content (>55%)
VA not a primary function
Aids regular corneal healing
Prevents eyelid from rubbing damage
cornea
Alleviates symptoms e.g. bullous
keratopathy
Maintains corneal hydration e.g. severe
dry eye conditions

8. Bandage Contact Lens
Indications for BCL
Recurrent Corneal Erosions
Stromal Dystrophies
Anterior Membrane Dystrophies
Persistent Epithelial defects & stromal ulceration
Corneal thinning & perforation
Cicatrizing conjunctival diseases
Bullous Keratopathy
Fuchs’ Endothelial Dystrophy
Neuroparalytic & neurotrophic Ulcers etc…..

9. Objective
General Objective
To find out the efficacy of bandage contact lens (BCL)
in corneal wound healing.
Specific Objective
To find out the common reason for BCL wear
To evaluate the duration of corneal healing
To find out the specific age group who are likely to
have corneal defects
To find out the duration of heal with respect to its
location

To find out the improvement in visual acuity

10. Methodology
Retrospective study
20 record files at Contact Lens Clinic, BPKLCOS
evaluated in detail
Study population
15 (who maintained regular F/U)
Recorded parameters
Age & gender, cause of wear, presenting VA &
final VA, location of defects, duration of healing &
microbial involvement

11. Methodology
Slit lamp Examination
Rule out obvious
contraindications
Evaluate CL fit
CL Fit & Evaluation

12. Bandage CL in-situ

13. Bandage CL in-situ

14. Results
Cause of BCL Wear
VKC with Shield
Ulcer, 34%
Infective Corneal
Ulcer, 20%
Recurrent
Corneal Erosion,
7%
Corneal
Abrasion, 13%
Traumatic
Corneal Ulcer,
13%
Sealed Corneal
Perforation, 13%

15. Results
Gender Distribution
Male
80%
Female
20%
1
11
3
0
2
4
6
8
10
12
No.
<16 yrs 16-40 yrs >40 yrs
Age Range
Age Distribution

16. Results
No. of
Patients
Improved to
6/6
Improved to
6/18
Improved to
6/36
No significant
improvement
6/6P – 6/18 8 8 - - -
6/24 – 6/60 1 - 1 - -
< 6/60 6 - 1 2 3

17. Results
3
1
5 5
0
1
2
3
4
5
No.
<1 w eeks1 w ks - 2
w ks
2w ks - 3
w ks
>3 w ks
Duration
Duration of Healing Location of Corneal Defects
Central, 6,
40%
Peripheral,
5, 33%
Paracentral,
4, 27%

18. Discussion
Rahim et al (1990) reported a high success rate when non
infected perforation, less than 3mm in size, were treated
with thin, high water content lenses worn for 1-2 weeks.
With the use of tissue adhesive and a bandage contact
lens, corneal perforation in 50% of the cases healed
completely. (Weiss et al, 1983).
Acheson et al, 1987 concluded that abrasions over 4mm
in size healed more quickly and cause less discomfort
than compared to occlusive pads.

19. Conclusion
VKC with sealed ulcer was the most common reason
for BCL wear.
Male: Female= 4:1
Patients having visual acuity < 6/12 were more than
half in number and all of them regained normal acuity
by the use of BCL.
Corneal defects were most likely among 16-40 years
aged.
Normal VA was restored in sterile corneal
defects/ulcers.
One-fifth of the cases were culture positive.
Normal duration for corneal wound healing was more
than 2 weeks.
Patients with peripheral and paracentral corneal
wounds had regained normal VA.

20. Recommendation
Bandage Contact Lens is a very
efficient device for corneal wound
healing.
Patients with several types of
corneal defects need emergent
referral for BCL wear so as to
restore the normal acuity.