Pr Eric E. GabisonCornea and ocular surface · Paris
FR EN
2 · Matrix, regenerative agents & supportive devices

Bandage / therapeutic contact lenses (BCL, scleral lenses)

Review — modulators of corneal healing2 · Matrix, regenerative agents & supportive devices › Bandage / therapeutic contact lenses (BCL, scleral lenses)

Bandage / therapeutic contact lenses (BCL, scleral lenses)

High-Dk silicone hydrogel; scleral lenses / PROSE · purely mechanical action

Oxford II–IV Moderate–Strong Present · mainstay
Mechanism of actionMechanical protection (splinting) of the regenerating epithelium against eyelid shear → uninterrupted migration/adhesion; covers exposed sub-basal nerves (pain relief); maintains hydration and a tear reservoir (scleral vaulting); tamponades micro-perforations. Can also serve as a drug reservoir.
IndicationsPED/recurrent erosions, post-surgery (PRK/CXL/PKP), bullous keratopathy (pain relief), filamentary keratitis, micro-perforations (with glue), retention of amniotic membrane. Caution in active infectious keratitis.
Route & dosageContinuous/extended wear from a few days to weeks, with topical antibiotic prophylaxis + preservative-free lubricants; scleral lenses worn during the day.
Level of evidenceOxford II–IV · Scale: Moderate–Strong (pain and closure after surgery), Moderate as an adjunct for PEDs.
FDASeveral lenses cleared (Class II/III) with a "therapeutic/bandage" and "extended wear" indication.
EU MACE-marked devices — standard availability.
FranceAvailable — standard of care.
USAAvailable, reimbursed.
AsiaAvailable.
Key studies: systematic review of post-surgical bandage lenses (2023) — PMID 37816246 ; numerous post-PRK RCTs (pain/re-epithelialization).
See also: Gabison E. “Corneal wound-healing agents”. In: SFO 2023 Report — Médicaments et biothérapies en ophtalmologie, chapter 21. Full text, open access (in French).

Prof. Eric E. Gabison — cornea and ocular surface, Paris