Comparison of the efficacy and safety of removing bandage contact lenses on the fourth and seventh postoperative day after transepithelial photorefractive keratectomy

PURPOSE: To compare the differences in the removal of bandage contact lenses (BCLs) at 4 and 7 days after transepithelial photorefractive keratectomy (TransPRK) in term of visual rehabilitation, eye discomfort, and postoperative complications. METHODS: This retrospective cohort study included patients with myopia undergoing TransPRK; in Group 1, the BCLs were removed on the 4th postoperative day, while in Group 2, the BCLs were removed on the 7th postoperative day. All patients underwent a 6-month follow-up, including slit-lamp examination and visual acuity assessment. Subjective evaluations of pain and eye discomfort were recorded after the BCLs removal. RESULTS: In total, 376 eyes of 191 patients in Group 1 and 346 eyes of 177 patients in Group 2 were enrolled. The two groups were matched for sex, age, preoperative corrected distance visual acuity, and tear film break-up time. Patients in Group 1 exhibited slightly lower levels of myopia, resulting in a shallower ablation depth and shorter ablation time than those in Group 2. No statistically significant differences in visual acuity recovery, haze severity, and incidence of infectious keratitis were observed within 6 months after surgery between the two groups. However, patients in Group 2 experienced significantly fewer discomfort symptoms (discharge, foreign body sensation, and blurred vision) after BCLs removal than patients in Group 1 and had fewer postoperative complications (recurrent corneal epithelial erosion). CONCLUSION: Delayed removal of the BCLs one week after TransPRK effectively alleviated early discomfort symptoms and reduced the risk of recurrent corneal epithelial erosion without increasing the likelihood of infectious keratitis.