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Ocular bandages result in reduced patient-reported symptoms compared with instant vision following cataract surgery, researchers found in a systematic review published in the Canadian Journal of Ophthalmology.
The eye protection ophthalmologists prescribe after cataract surgery varies, and there are no established recommendations on best practices, researchers explain. They systematically reviewed existing regimens and patients’ subsequent symptoms.
The researchers searched Ovid MEDLINE, EMBASE, and Cochrane CENTRAL from 2000 through April 2021 for original research articles that reported the following symptoms associated with eye protection following cataract surgery in adult patients: foreign-body sensation (FBS), tearing, photophobia, subjective symptom scores, Ocular Surface Disease Index (OSDI) scores, corneal wound architecture, best-corrected visual acuity (BCVA), and tear breakup time (TBUT). They excluded studies with high risk of bias across all assessment domains.
The 8 identified studies evaluated ocular bandages (n=6), eye patches (n=4), instant vision (n=2), and eye shields (n=1). One nonrandomized study of 51 eyes had high quality, according to the Newcastle-Ottawa scale.
One prospective RCT found that OSDI scores and subjective symptom scores of patients who received ocular bandage were significantly lower and TBUT was significantly higher 1 and 2 weeks after surgery compared with patients who did not receive the bandages.
A 2018 prospective RCT found that ocular bandage was associated with increased TBUT compared with eye patches.
In a 2017 prospective RCT, patients were less likely to have epithelial gaping if they had received eye patches (52.4%) compared with eye shields (74.2). Researchers who compared liquid adhesive ocular bandage, nylon suture, and standard stromal hydration (each in combination with topical anesthetic and intraoperatively) found that the group that received ocular bandage had the lowest mean FBS scores.
In another prospective RCT, patients who received ocular bandages were less likely to report pain compared with individuals in the instant vision group to report pain at 1 and 6 hours but not at 24 hours postoperatively. Patients preferred ocular bandages, instant vision with low-viscosity tears, or high-viscosity tears over instant vision. TBUT was lowest in the instant vision group 1 day postoperatively.
Patients who received eye patch in 1 eye and instant vision in the opposite eye tended to report immediately after bilateral cataract surgery pain in the instant vision group rather than the eye patch group, a study found. After 24 hours, eyes that received eye patches had higher TBUT. The majority (65%) of patients preferred the eye patch to instant vision while 27% had no preference.
Researchers who compared ocular bandages and eye patches reported that patients with ocular bandages had higher OSDI scores at 1 week, 1 month, and 3 months postoperatively and better TBUT at 1 week postoperatively.
In a study of patients who received ocular bandages, 61% reported FBS, irritation, or discomfort 1 day after surgery and 61% reported conjunctival hyperemia. Five to 8 days postoperatively, 6 patients reported FBS, irritation, or discomfort.
Limitations of the study included an inability to provide meta-analysis and a lack of guidance in optimal eye protection duration or regimen.
Disclosure: Some study authors declared affiliations with biotech, pharmaceutical, and/or device companies. Please see the original reference for a full list of authors’ disclosures.
Reference
Dhoot AS, Popovic MM, Lee S, et al. Eye protection following cataract surgery: a systematic review. Can J Ophthalmol. Published online December 1, 2021. doi:10.1016/j.jcjo.2021.11.001
