Modified Soft Contact Lens During Vitrectomy

Effect of a Modified Soft Contact Lens Combined With a Noncontact Wide-Angle Viewing System During Vitrectomy

This study compared a modified soft contact lens with balanced salt solution irrigation during pars plana vitrectomy performed with a noncontact wide-angle viewing system. Participants requiring vitrectomy were randomly assigned to have the modified lens placed on the cornea throughout surgery or to receive intermittent balanced salt solution irrigation. The study evaluated whether the modified lens could maintain a clear surgical view and protect the corneal surface. Participants were followed for one month after surgery.

This prospective, randomized, parallel-group study enrolled patients with retinal diseases requiring pars plana vitrectomy at Xi'an First Hospital. All operations were performed by the same experienced vitreoretinal surgeon using a standard three-port procedure and the RESIGHT noncontact wide-angle viewing system. In the modified soft contact lens group, a silicone hydrogel corneal bandage lens modified to a diameter of 10.5 mm was placed after surgical draping and maintained throughout the operation. In the comparator group, balanced salt solution was applied intermittently to maintain corneal hydration and clarity.

Intraoperative assessments included total operative time, vitrectomy duration, frequency of corneal irrigation, and graded clarity of the surgical field. Corneal epithelial edema, fluorescein staining, tear film breakup time, and central corneal thickness were assessed before surgery and at 1 day, 1 week, and 1 month after surgery. Ocular surface symptoms were assessed using the Ocular Surface Disease Index before surgery and at 1 month.

Inclusion Criteria:

• Diagnosis of a retinal disease requiring pars plana vitrectomy.
• Corneal endothelial cell density of at least 2,000 cells/mm².
• No ocular surface disease or significant anterior-segment abnormality.
• No ocular surgery or trauma within the previous month, except intravitreal anti-VEGF injection.
• Considered suitable for ophthalmic surgery under routine clinical conditions.

Exclusion Criteria:

• Refusal to participate or withdrawal from the study.
• Syncope or inability to tolerate study examinations or surgery.
• Incomplete study data.
• Any condition judged by the investigator to interfere with corneal assessment, including corneal edema secondary to persistently elevated intraocular pressure.