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Managing corneal epithelial defects using high molecular weight fluorescein to prevent staining and removal of bandage contact lenses

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Session Details

Session Title: Presented Poster Session: Cornea III

Venue: Poster Village: Pod 2

First Author: : C.Gunasekera UK

Co Author(s): :    R. Allen   E. Hewson   A. Mukherjee        

Abstract Details

Purpose:

Corneal epithelial defects can be caused by Ophthalmologists in laser-assisted subepithelial keratomileusis (LASEK), photorefractive keratectomy (PRK) and corneal cross-linking. A bandage contact lens can be fitted to reduce pain and promote epithelial healing. Assessment of epithelial defects is difficult without fluorescein. Fluorescein stains bandage contact lenses and new lenses are required for each assessment. Fitting new lenses may disrupt epithelium and delay healing. High molecular weight fluorescein (e.g. Fluorosoft) does not stain contact lenses and is commonly used to fit contact lenses. We assessed if Fluorsoft can be used to diagnose epithelial defects, prevent bandage contact lens staining and removal.

Setting:

Colchester University Hospital NHS Foundation Trust, UK

Methods:

Patients with epithelial defects requiring bandage contact lenses were identified. We used both Biofinity contact lenses and Purevision lenses. Anterior segment photography was taken without fluorescein initially. Fluorosoft was added and a repeat anterior segment photograph was taken after 30 seconds to ensure Fluorsoft entered under the lens. The bandage contact lens was removed and photographed to assess for staining. The patient had regular fluorescein added and another anterior segment photograph was taken to compare the visibility of the epithelial defect with regular fluorscein compared to Fluorosoft.

Results:

5 patients met the inclusion criteria and imaging was performed. Side by side comparison of the imaging will be presented. There was no difference in the area of epithelial staining with Fluorosoft compared to fluorescein. Fluorosoft also did not show any staining of the bandage contact lenses.

Conclusions:

This study shows that high molecular weight fluorescein (Fluorosoft) can effectively identify epithelial defects in patients wearing a number of bandage contact lenses without staining the lens. Epithelial defects managed with Fluorosoft and bandage contact lenses do not require frequent lens removal for diagnosis. The benefits of management may include improved healing, less discomfort to patients from frequent lens removal and fewer lenses required for procedures. This would be of interest to ophthalmologists performing corneal cross-linking, LASEK and PRK.

Financial Disclosure:

NONE

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