|Year : 1983 | Volume
| Issue : 7 | Page : 951-953
Our experience with bandage lenses
Sankara Netharalaya Medical Research Foundation, 18, College Road, Madras, India
T S Surendran
Sankara Netharalaya Medical Research Foundation, 18, College Road, Madras 6
Source of Support: None, Conflict of Interest: None
|How to cite this article:|
Surendran T S. Our experience with bandage lenses. Indian J Ophthalmol 1983;31, Suppl S1:951-3
Bandage soft contact lenses have proven to be a highly effective tool in the management of number of corneal problems. These include dry eye syndromes, bullous keratopathy, ocular pemphigps, filamentary keratitis, exposure keratitis etc. Therapeutic use of soft contact lens has several goals and include visual improvement, comfort, protection of cornea etc. Warner Lambert Softcon bandage lenses were used in our study.
| Material and methods|| |
In our series, 28 eyes of 21 patients were studied. All were fitted with SOFTCON bandage lenses made from vifilcon A from Softcon Division, USA. These lenses are available in varying diameters from 12.5 to 15.5 mm and radii of curvature from 7.2 to 8.7 mm. We had BC's of 7.5, 7.8, 8.1 and 8.4 mm. The water content was 55% and 45% vifilcon A (a soft hydrophilic polymer of 2 hydroxy ethyl methadrylate and poridone). For fitting keratometry is performed if possible first as in fitting of other lenses. Then determination of lens power, evaluation of lens power by keratometry over the lens and biomicroscopy is performed. Test lens size is then determined as per [Table - 1]. Thus following the rule of thumba steep cornea is a small cornea and a flat cornea is a large cornea. Evaluation of power is like in other soft lenses. A trial lens is fitted and fitting is assessed 2 hours later and then 24 hours later. Corneal lens relationship, movement with each blink etc., are assessed. Biomicroscopy is done and relationship of lens edge to sclera, appearance of lens surface, evaluation of cornea, conjunctiva, enlarged vessels, ciliary flush, lens centration, lid pressure or effect of lid on lens movement are then assessed.
The bandage lenses were fitted in 5 patients of dry eye syndrome (10 eyes), bullous keratopathy in 4 patients (4 eyes), persistent corneal edema in 2 patients (2 eyes), one following cataract extraction and other following vitrectomy and cataract extraction, filamentary keratitis in 4 patients (6 eyes), ocular pemphigus in 1 patient (1 eye), patients with corneal problems following vitrectomy 2 patients (2 eyes), exposure keratitis in 1 patient (2 eyes) and status post pterygium surgery in one patient to prevent symblepharon (1 eye) [Table - 2].
Different base curves used were indicated in [Table - 3].
Lenses were kept for more than 3 months in 14 eyes, up to 1 month in 6 eyes, between 10 days to 1 month in 2 eyes and were removed next day in 6 eyes because of intolerance, of which 5 were due to intolerance tp the lenses and 1 due to corneal ulcer [Table - 4].
| Observations and discussion|| |
We had excellent results with all dry eye syndromes except one who developed corneal ulcer on the 4th day [Table - 5], and we had very good results with filamentary keratitis. They were relieved of subjective symptoms like foreign body sensation and pain and also increase in visual acuity was noted in all cases. The patient with ocular pemphigus did not do well and lens had to be removed next day because of intolerance. We had 2 cases of corneal decompensation following vitrectomy through pars plana and both developed corneal erosions and vascularisation. Both these patients were on bandage lenses for nearly 2 months and remarkable improvement in the symptons. One patient with exposure keratitis in both eyes - following thyrotoxicosis and he did remarkably well with bandage lenses. In one patient we fitted these lenses on the table following surgery for recurrent pterygium with symblepharon to prevent recurrent symblepharon. All patients with bullous keratopathy, fitted with these lenses were relieved of the pain completely and were having these lenses for months together without any problem. The longest follow up period in our series was more than one year [Table - 4]. The vision increased to some extent in 2 cases of persistent corneal edema after fitting with bandage lenses and the edema also subsided to some extent. These patients had the lenses for a long time.
The most common problems found in our series with corneal diseases were decreased vision and pain. In most of these cases like dry eyes the main cause of loss of vision was irregular corneal astigmatism and pain secondary to epithelial breakdown exposure of the corneal nerves. After fitting these patients with bandage lenses we were trying to protect the epithelium without causing injury and major hazards.
| Summary|| |
In conclusion the SOFTCON bandage lenses have revolutionised the management of corneal diseases. They have relieved pain and in many cases with remarkable visual improvement In dry eyes with conjunctival cicatrization, bandage lenses have a special place because of relatively poor prognosis. These patients were also given supportive therapy of artificial tears and application of saline and antibiotic drops.
[Figure - 1], [Figure - 2]
[Table - 1], [Table - 2], [Table - 3], [Table - 4], [Table - 5]