Outline
I.
Therapeutic Contact Lenses
A.
Historical Perspectives
1.
Celsus -> Ridley -> Kaufman & Gasset -> Aquavella
B.
Rationale For Their Applications
C.
Therapeutic Efficacy
II.
Therapeutic Contact Lens Efficacy
A.
Pain Relief
B.
Protection & Splinting
C.
Wetting
D.
Visual Performance
E.
Drug Delivery
III.
Hydrophilic Bandage Lenses
A.
Properties
1.
Flexibility / Dimensional Stability / Oxygen Permeability
B.
Lens Typing & Indications
1.
High Water Content
a.
Bullous Keratopathy / Superficial Punctate Keratitis
2.
Mid Water Content
a.
Epithelial Defects / Descemetocele / Perforation
3.
Low Water Content
a.
Recurrent Corneal Erosion (?) / Keratitis Sicca / Trichiasis
IV.
Clinical Indications
A.
Bullous Keratopathy
B.
Persistent Epithelial Defect
C.
Recurrent Corneal Erosion
D.
Corneal Abrasion
E.
Keratoconjunctivitis Sicca
F.
Thygeson’s Keratitis
G.
Corneal Perforation
H.
Post-Operative Applications
1.
PRK / LASIK / PK / Laceration Repair
V.
Disposable Hydrophilic Lenses As Bandages
A.
Are They Viable?
1.
WARNING: This Is An Off-Label Application
B.
How Should They Be Prescribed?
C.
Is Adjunct Treatment Indicated?
VI.
Disposable Hydrophilic Bandage Lenses – A Report Card
A.
39 Patient Study (5 – 89 YOA / 25 F & 14 M)
B.
Acuvue (J&J) / SeeQuence (B&L)
C.
Medical & Surgical Indications
D.
Prescribing Patterns
1.
1 Day – 8 Weeks ( Mean = 11 Days)
2.
Adjunct Therapy
a.
Lid Hygiene / Lubrication / Antibiotics / Steroids
3.
Prophylactic Antibiotic Therapy
E.
F.
VII.
a.
Epithelial Defects / Keratitis Sicca / Post Surgical Care
Results
1.
Patient Symptoms Improved In 35/39 Patients (90%)
2.
Patient Signs Improved In 34/39 Patients (87%)
3.
Relative Indications
a.
Epithelial Defects / Bullous Keratopathy / Post Surgical Pain
4.
Relative Contraindications
a.
Foreign Body Removal / Filamentary Keratitis / Keratitis Sicca
5.
Complications
a.
Lens Loss – 11/39 Patients (28%)
b.
Lens Spoilage – 2/39 Patients (5%)
c.
Acute Red Eye – 1/39 Patients (2.5%)
d.
Infectious Keratitis – 1/39 Patients (2.5%)
Advantages & Disadvantages
Silicone Hydrogel Bandage Lenses
A.
Examples
1.
Bausch & Lomb PureVision (DK/t = 110)
2.
Ciba Focus Night & Day (DK/t = 175)
B.
Attributes
1.
High Oxygen Transmission
2.
Deposit Resistance
3.
On Eye Mobility
C.
Clinical Indications
1.
Acute / Temporary Applications
2.
Chronic / Continual Applications