Therapeutic contact lenses vs. tight bandage patching and pain following pterygium excision: a prospective randomized controlled study

Purpose The immediate postoperative management of patients undergoing pterygium excision usually includes eye patching in order to alleviate pain and prevent accidental tissue damage. Commonly applied tight patching with gauze bandages results in decreased field of monocular vision and discomfort. The aim of this study was to evaluate the patient-centered outcome of pterygium surgery when therapeutic contact lenses (TCL) are used instead of tight bandage patching in the first 24 postoperative hours. Methods Prospective randomized controlled study. Sixty patients with primary pterygium who underwent pterygium surgery consisting of conjunctival autografting with 10–0 Vicryl sutures were randomized into two groups, bandaged with TCLs and tight bandage patching. Main outcome measures: Degree of pain on an 0–10 scale, use of pain killers, level of patient discomfort, sleep quality, and visual acuity (VA). Results Sixty patients were studied. The pain level and pain duration during the first postoperative day was significantly lower in the tight bandage patching group compared with the TCL group (P =0.034,P = 0.04 respectively). Sleep quality was significantly poorer in the TCL group (P = 0.004). The VA on the first postoperative day was similar for the two groups. Conclusions The application of TCL in the first 24 h after pterygium surgery resulted in more discomfort and pain and decreased quality of sleep compared with tight bandage patching. Despite the limitation in monocular vision and the inconvenience of gauze bandages, they are preferred over TCL for alleviating pain following pterygium surgery.