Efficacy Of Bandage Contact Lenses In Treatment Of Noninfectious Corneal Perforations

Objective:To explore the role of bandage contact lenses in the non-operative treatment of noninfectious corneal perforations,the effectiveness,safety and limitation of bandage contact lenses were analyzed,and the clinical curative effect of bandage contact lenses on noninfectious corneal perforations were evaluated.Methods:A retrospective study reviewed case records with noninfectious corneal perforations,who underwent bandage contact lenses and adjuvant medication from June 2014 to June 2015 at the Department of Ophthalmology of the Second Affiliated Hospital Zhejiang University College of Medicine.Before BCL application,the microbiological diagnosis were required for their corneal scrapings,to exclude infectious corneal perforations caused by bacteria,viruses,fungi and acanthamoeba and so on.We evaluated subjective symptoms,and assessed ocular surface by using slit-lamp microscopy,anterior segment photography and corneal fluorescein staining before and after BCL application.Visual acuity,intraocular tension,anterior chamber formation and the repair process of corneal perforations throughout the follow-up period were recorded.The possible complications during the use of BCLs were also recorded.Results:Nineteen patients were studied(mean age 49.11±23.83 years,range 11-91 years),included fourteen men and five women.There were 4 cases with exposure keratitis ulcer,4 cases with trauma,3 cases with neurotrophic corneal ulcers,3 cases with chronic graft-versus-host disease(GVHD),3 cases with cataract surgery,1 case with pterygium resection and 1 case with chemical burns.The efficacy of 19 patients included:9 cases of impending corneal perforations were healed without further corneal perforations.In 10 cases of full-thickness corneal perforations,8 cases of corneal perforations were successfully sealed,recovered the depth of anterior chamber and restored the ocular surface morphology effectively.1 case lead by GVHD with the area of corneal unlcer was expand after BCL application.and accepted corneal transplantation finally.And 1 case wore off the BCL due to instability.During the total follow-up period,no evidence of subsequent infection,sight-threatening related to contact lenswear was detected in any patient.Conclusion:These findings suggest that the use of bandage contact lenses may be a safe and effective adjuvant therapy for noninfectious corneal perforations,with clinical application as relatively simple,convenient and inexpensive temporary measures to improve the condition of the cornea for further definitive interventions.