Discussion
ocular pain, corneal dehydration, corneal crosslinking, pain, haze, lens, keratoconus, postoperative corneal edema, dry eye symptoms
INFILTRATION, EPITHELIALIZATION, ADVERSE EFFECTS, LENS, MEIBOMIAN GLAND DYSFUNCTION, KERATOCONUS, DRY EYES SYNDROME
Ensuring patient comfort and satisfaction is a top priority in healthcare systems. Application of bandage contact lens could effectively promote epithelialization and ease the postoperative symptoms after corneal crosslinking [Through rigorous observation, we discovered that it was feasible for patients to remove their lenses only 3 days after the procedure. This finding has the potential to significantly reduce the interval between follow-up visits and increase patient satisfaction, particularly for those traveling from other provinces or suburban areas to receive medical treatment.In subjective ocular assessment, patients in group B, who removed the lens after 3 days, experienced less ocular pain at day 7 with a score of 0.01 ± 0.40 than those in group A, who removed the lens after 7 days with score of 0.12 ± 0.29. As pain is one of the concerning postoperative matters in CXL surgery, the results of the present study could serve as a reliable reference for future keratoconus post-CXL care. In terms of subjective ocular signs, group B displayed lower scoring results than group A in postoperative corneal edema for day 5 and 7, which were 0.10 ± 0.13 and 0.03 ± 0.07, respectively, for group B and 0.17 ± 0.14 and 0.08 ± 0.11, respectively, for group A.Compared with conventional “epi-off” CXL, the corneal epithelium is removed by applying an infiltration enhancer that assists the thorough infiltration of riboflavin into the corneal stroma. The latter method can effectively eliminate the consequent adverse effects caused by the absence of an epithelial layer, such as corneal dehydration, subepithelial haze, and endothelial disruption [In this study, we found that dry eye symptoms lasted the longest among all negative ocular signs. Several studies have demonstrated the correlation between CXL and dry eyes syndrome. In postoperative transepithelial CXL, a marked reduction has been observed in non-invasive tear break-up time (NITBUT), increased ocular surface disease index (OSDI), and impaired meibomian gland dysfunction [This study has several limitations. As the present study was based on the subjective sensations of the participants, each patient’s identity and profile, such as educational background or comprehension ability, could equally influence the results. Further investigations that incorporate more subjective parameters are required. Moreover, tolerance of the lens for these two groups was not examined prior to the intervention, which may have also affected the results of the study.In conclusion, 3 days is regarded as a desirable period for wearing corneal lenses in postoperative trans-epithelial CXL, showing satisfactory results in clinical observation, delivering better ocular sensation, and sufficient visual quality for patients with keratoconus.