Short-term OCT-based evaluation of corneal epithelial remodeling with two silicone hydrogel bandage contact lenses after t-PRK.

PURPOSE: To compare short-term corneal epithelial thickness changes measured by optical coherence tomography (OCT) in eyes fitted with two different silicone hydrogel bandage contact lenses (BCL) following trans-epithelial photorefractive keratectomy (t-PRK).

METHODS

In this prospective contralateral-eye study, 60 eyes of 30 patients with myopia without astigmatism underwent t-PRK using WaveLight EX500 excimer laser. Balafilcon A was applied to one eye and senofilcon A to the fellow eye in a randomized manner. All BCLs were removed on postoperative day 5. Corneal epithelial thickness was assessed preoperatively and on postoperative days 5, 15, and 30 using spectral-domain optical coherence tomography (REVO FC). Measurements were obtained centrally and across eight mid-peripheral quadrants. Epithelial thickness and spherical equivalent (SE) were compared.

RESULTS

The mean age of the participants was 27.11 ± 6.80 years. Preoperatively, no significant differences were observed between the groups in SE (- 2.93 ± 1.11 D vs. - 2.71 ± 1.44 D; p = 0.353), ablation depth, central corneal thickness, or epithelial thickness. On postoperative day 5, slightly higher epithelial thickness values were observed in the nasal, temporal, and superotemporal quadrants in the balafilcon A group in unadjusted analyses; however, these differences did not remain statistically significant after false discovery rate correction. No significant differences were observed between the other regions. By postoperative days 15 and 30, epithelial thickness was comparable across all quadrants. At 1 month, the SE values were similar (p = 0.302), although balafilcon A showed a trend toward values closer to emmetropia.

CONCLUSIONS

Both bandage contact lens materials demonstrated broadly comparable short-term postoperative epithelial remodeling patterns and refractive outcomes after t-PRK. Minor early regional differences observed on OCT should be interpreted cautiously.