Bandage contact lens and topical indomethacin for treating persistent corneal epithelial defects after vitreoretinal surgery.

摘要

PURPOSE: Persistent corneal epithelial defect is a complication of vitreoretinal surgery. We assessed the efficacy of using bandage contact lenses in conjunction with topical indomethacin to facilitate wound healing and control pain safely. METHODS: Patients presenting with a persistent corneal epithelial defect after vitreoretinal surgery were assigned randomly to 1 of 2 treatment groups. Patients in both groups received a therapeutic contact lens and chloramphenicol eyedrops, whereas group A received indomethacin eyedrops and group B received placebo eyedrops. This study was conducted in a single-masked randomized fashion. Patients were evaluated daily to monitor subjective symptoms and to measure the maximum and minimum dimensions of the epithelial defects. RESULTS: Sixteen patients were analyzed. The subjective evaluation of photophobia, foreign-body sensation, and tearing on the day after starting treatment did not differ significantly between the 2 groups (P > 0.05), whereas the difference in themean pain decrease between groups A and B at day 1 was significant (P = 0.01). The rate of epithelial healing quantified as the days needed to heal the epithelial defect did not differ between the 2 groups (P = 0.823). CONCLUSIONS: Our study showed that topical indomethacin ophthalmic solution improves comfort in patients with a persistent corneal epithelial defect (after vitreoretinal surgery) treated with bandage contact lenses.