Bandage lenses are important tools for the treatment of ocular surface disease and other corneal conditions. Bandage contact lenses protect the cornea from environmental conditions and counter the abrasive effects of the patient’s own eyelids. Using these lenses can help repair tissue, manage pain, and maintain visual acuity. Bandage contact lenses are indicated for the following reasons:
One important indication for therapeutic lenses is to protect the cornea in eyes with entropion, trichiasis, or exposed suture knots. For these conditions, soft bandage contact lenses should be considered a temporary measure until a structural solution is achieved. For eyes with erosion of the ocular surface due to epithelial dystrophy or following ocular trauma, first-line therapy is nightly treatment with hypertonic drops and/or ointment before the patient sleeps. If this treatment is ineffective, however, a bandage contact lens should be applied before phototherapeutic keratectomy is considered. Bandage lenses must be used until the epithelial adhesion complex has fully recovered—at least 2 months. These lenses may also improve small irregularities of the ocular surface, which can in turn improve visual acuity.
Corneal erosion, bullous keratopathy, and filamentary keratitis can cause patients intense pain. The application of soft bandage contact lenses often provides measurable relief for patients who experience these conditions. One should not apply bandage lenses in eyes with corneal erosion resulting from trauma, however, because the wound might be infected. In eyes that have previously undergone corneal abrasion for laser surgery or CXL treatment, one should consider the use of a bandage contact lens to manage pain and accelerate wound healing. For many conditions, soft bandage contact lenses can help limit the acute pain that patients experience. A patient’s quality of life can be significantly improved through the use of therapeutic lenses.
There are several conditions for which surgeons must actively encourage epithelial repair. These include neurotrophic keratitis, chemical burns, and after cornea transplant. Neurotrophic keratitis is challenging to manage. Among the several therapeutic options at the physician’s disposal, bandage lenses have the advantage of preserving the patient’s visual acuity, visual field, and binocular vision.
Bandage lenses can temporarily stop leaking wounds after cataract surgery. For small perforations, the lens may be effective in reshaping the anterior chamber, with or without the use of an adhesive. After glaucoma surgery, large-diameter bandage lenses can also help to manage excessive filtration.
The therapeutic effects of bandage lenses make these devices highly versatile. Bandage lenses protect the cornea and facilitate the growth and protection of epithelial cells. Soft bandage contact lenses can play an important role after surgery. By fully understanding the indications for these lenses, physicians can facilitate healing, relieve pain, and mitigate the risks of infection for their patients.