Clinical Observation of Early Postoperative Wear of Balafilcon A and Innovative First-Generation Samfilcon A Silicone Hydrogel Bandage Contact Lenses after SMILE Surgery

Clinical Observation of Early Postoperative Wear of Balafilcon A and Innovative First-Generation Samfilcon A Silicone Hydrogel Bandage Contact Lenses after SMILE Surgery | Research Square window.SnipcartSettings = { analytics: { enabled: false } }; (function() { var accessVector = localStorage.getItem('access_vector') || ''; window.dataLayer = window.dataLayer || []; if (accessVector) { window.dataLayer.push({ user: { profile: { profileInfo: { snid: accessVector } } } }); } })(); (function(w,d,s,l,i){w[l]=w[l]||[];w[l].push({'gtm.start':new Date().getTime(),event:'gtm.js'});var f=d.getElementsByTagName(s)[0],j=d.createElement(s),dl=l!='dataLayer'?'&l='+l:'';j.async=true;j.src='https://www.googletagmanager.com/gtm.js?id='+i+dl;f.parentNode.insertBefore(j,f);})(window,document,'script','dataLayer','GTM-K279D39R'); Browse Preprints In Review Journals COVID-19 Preprints AJE Video Bytes Research Tools Research Promotion AJE Professional Editing AJE Rubriq About Preprint Platform In Review Editorial Policies Our Team Advisory Board Help Center Sign In Submit a Preprint Cite Share Download PDF Short Report Clinical Observation of Early Postoperative Wear of Balafilcon A and Innovative First-Generation Samfilcon A Silicone Hydrogel Bandage Contact Lenses after SMILE Surgery Shisi Hu, Hui Ding, Xiaodan Chen, Shanxiang Li, Zhenduo Yang, and 1 more This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-5407465/v1 This work is licensed under a CC BY 4.0 License Status: Published Journal Publication published 27 Oct, 2025 Read the published version in BMC Research Notes → Version 1 posted 4 You are reading this latest preprint version Abstract Purpose: To compare the efficacy of two different silicone hydrogel bandage contact lenses on ocular surface after small incision lenticule extraction (SMILE) surgery. Methods: In this prospective, double-masked, contralateral, comparative clinical study, 25 patients who received SMILE in both eyes wore two different silicone hydrogel bandage contact lenses (BCLs): balafilcon A in one eye and samfilcon A in the other randomly. The scores of BCL deposits on the lens surface and the level of ocular discomfort were assessed on the first day after surgery. Ocular Surface Disease Index (OSDI), the 5-Item Dry Eye Questionnaire (DEQ-5), corneal sensitivity, ocular surface parametersand tear inflammatory mediators were assessed preoperatively and 1 day, 1 week, and 1 month postoperatively. Results: The scores of BCL deposits were lower in the samfilcon A group than that in the balafilcon A group (samfilcon A vs. balafilcon A: 1.28±0.68 vs. 2.56±0.82, P=0.045). There were no significant differences in subjective symptoms scores, OSDI scores, DEQ-5 scores, corneal sensitivity, ocular surface parameters or tear inflammatory mediators between the BCLs postoperatively (p>0.05). Conclusion: Both samfilcon A and balafilcon A contact lenses are safe with equivalent efficacy on ocular surface after SMILE. Samfilcon A caused significantly less deposits after SMILE. Silicone hydrogel Contact lenses SMILE Ocular surface Figures Figure 1 Figure 2 Figure 3 Introduction In recent years, small incision lenticule extraction (SMILE) has become a mainstream refractive correction surgery due to its advantages in effectiveness, safety, and stability [ 1 , 2 ]. However, in the early postoperative period, some patients still report discomfort symptoms such as foreign body sensation, pain, and dry eyes. Bandage contact lenses (BCLs) are often used to promote corneal wound healing after refractive surgery and to alleviate postoperative irritation symptoms [ 3 – 5 ]. Studies have shown that early postoperative wear of silicone hydrogel BCLs after SMILE surgery can improve subjective discomfort symptoms, enhance overall patient comfort, and reduce corneal edema [ 6 ]. Balafilcon A and samfilcon A are two types of silicone hydrogel BCLs made from different materials and design processes. The innovative first-generation samfilcon A silicone hydrogel bandage lens has superior properties in terms of oxygen permeability, water content, and thickness. This study prospectively observes the clinical effects of wearing two different silicone hydrogel BCLs in the early postoperative period after SMILE surgery, comparing their effects on postoperative comfort and ocular surface function, providing reliable reference for the selection of postoperative BCLs. Materials and methods General information Twenty-five cases (50 eyes) of patients with refractive error who underwent bilateral SMILE surgery in May 2023 at Hainan Eye Hospital were observed. Among them were 13 females and 12 males, with an average age of 25.72 ± 4.64 years. This is a prospective, randomized, double-blind, self-controlled study, following the principles of the Declaration of Helsinki, and was approved by the Ethics Committee of Hainan Eye Hospital. All patients were informed and signed an informed consent form. Inclusion criteria (1) Age ≥ 18 years; (2) Best corrected visual acuity ≥ 1.0; (3) Spherical power ≥-8.00 D, cylindrical power ≤ 3.00 D. Exclusion criteria (1) Eye parameters not meeting surgical requirements, presence of anterior or posterior segment diseases, or active inflammation affecting surgery; (2) Presence of systemic diseases that may affect postoperative vision or delay healing; (3) Pregnant or lactating women. Surgical method The surgery was performed using the German ZEISS VisuMax femtosecond laser system, with all surgeries completed by the same surgeon. All patients received surface anesthesia with 0.5% proparacaine hydrochloride eye drops. The parameters were set as follows: lenticule diameter of 6.0–6.5 mm, cap thickness of 110–120 µm, cap diameter of 7.5 mm, and lenticule incision of 2 mm. After completing the femtosecond laser scan, the laser-cut stromal lenticule was removed through the lenticule incision. Finally, the corneal stromal bed was thoroughly rinsed with a balanced solution. After the surgery, another physician, according to a random number table, provided the corresponding BCLs to the surgeon. One eye was fitted with balafilcon A (Pure Vision, Bausch & Lomb, USA) and the other eye was fitted with samfilcon A (ULTRA, Bausch & Lomb, USA) (Table 1 ). Neither the surgeon nor the patients were aware of the eye assignments for the two types of BCLs. The physician who assigned the BCLs did not participate in the subsequent treatment and examinations of the patients. The BCLs were removed from both eyes on the first postoperative day. Table 1 Comparison of parameters for two types of corneal contact lenses Brand Samfilcon A group Balafilcon A group Water content 46% 36% Oxygen permeability (DK/t) 137 101 Elastic modulus (mPa) 0.69 1.1 Central thickness (mm) 0.07 0.09 Lens diameter (mm) 14.2 14.0 Base curve (mm) 8.5 8.6 Preoperative and postoperative medication Preoperatively, 0.5% levofloxacin eye drops were used four times a day for 3 days. Postoperatively, 0.5% levofloxacin eye drops were used four times a day for 7 days; 0.3% tobramycin dexamethasone eye drops were used four times a day for 3 days; 0.5% loteprednol etabonate suspension eye drops were used four times a day from the fourth day aftter surgery to the fourteenth day; and 0.1% sodium hyaluronate eye drops were used four times a day for 30 days. Evaluation indicators The examining physician removed the BCLs 1 day postoperatively and evaluated the surface deposits on the lens. The BCLs is divided into five areas: upper, lower, nasal, temporal, and central. The score range from 0 to 3 is based on the density of the surface deposits on the lens. A score of 0 indicates no protein deposits and 3 indicates dense protein deposits. The sum of the scores for each area is calculated. Then patients were immediately asked to score their subjective ocular symptoms, including stinging sensation, foreign body sensation, and tearing. Each symptom is scored separately, with 0 indicating no discomfort and 10 indicating the highest degree of discomfort. Visual acuity, Ocular Surface Disease Index (OSDI), 5-Item Dry Eye Questionnaire (DEQ-5) scores, eyelid margin hyperemia scores, conjunctival hyperemia scores, tear breakup time (TBUT), fluorescein staining (FL) scores, tear meniscus height (TMH), corneal sensitivity measurements, basic tear secretion test (Schirmer I test [SIT]) and tear inflammatory mediators were assessed preoperatively and at 1 day, 1 week, and 1 month postoperatively. ①Patients answer the questionnaires based on their own conditions, and the scores of OSDI and DEQ-5 are verified and recorded. ②TBUT and SIT were evaluated on all participants as described[ 7 ]. ③The score of eyelid margin hyperemia is assessed as follows: 0: normal color; 1: the involvement of pinkish capillaries; 2: deep pink or red confluent capillaries in localized areas; 3: deep red, diffuse, confluent capillaries. ④The score of conjunctival hyperemia is assessed as follows: 0 : no vessel dilation; 1 : occasional vessel dilation in the fornix; 2: mild hyperemia with slightly blurred vessel outlines; 3: moderate hyperemia approaching the limbus with tortuous vessels; 4: severe hyperemia involving the entire bulbar conjunctiva with indistinct vessel pathways. ⑤The corneal fluorescein staining is observed under cobalt blue light in a slit-lamp microscope and scored in upper, lower, nasal, temporal, and central areas of cornea as follows: 0: no staining; 1༚less than 15 points of staining; 2༚16–30 points of staining; 3: more than 30 points of staining or the presence of confluent staining. The sum of the scores for each area is calculated. ⑥TMH is measured three times using the Gaush iDea ocular surface interferometer and the average value is recorded. ⑦Corneal sensitivity is measured in the upper, lower, central, nasal, and temporal areas using a Cochet-Bonnet esthesiometer. The measurement starts at 60 mm; if there is no sensation, it is decreased by 5 mm increments until the patient feels the filament. The average value of each area is calculated. ⑧Tear samples were also collected to detect the expression of interleukin-1α (IL-1α) and intercellular adhesion molecule-1 (ICAM-1). Tear samples are collected for RNA extraction. Reverse transcription and real-time quantitative polymerase chain reaction detection are performed according to the instructions of the Reverse Transcriptase M-MLV (RNase H-) kit (TAKARA, Japan). Based on the Ct values of each gene, the comparative delta-delta Ct method is used: △△Ct = (Ct gene - Ct reference gene) - (Ct gene - Ct reference gene control group), and the relative expression levels of each gene compared with the control group are calculated using the 2 ^−△△CT formula. Statistical analysis Data analysis was performed using SPSS 27.0 software. The Kolmogorov–Smirnov test was used to check the normality of the measurement data. For normally distributed data, the independent sample t-test was used for intergroup comparisons; for non-normally distributed data, the Wilcoxon rank-sum test was used. Repeated measures analysis of variance was used to compare different time points for repeated measurement data, with post hoc pairwise comparisons performed using the least significant difference t-test. For repeated measurement data that did not meet the requirements for analysis of variance, the generalized linear model was used for comparison across different time points, and post hoc pairwise comparisons were adjusted for significance using the Bonferroni method. Data are presented as mean ± standard deviation, and P < 0.05 was considered statistically significant. Results There were no statistically significant differences between the two groups in preoperative equivalent spherical refraction, theoretical ablation depth, and preoperative best corrected visual acuity (corrected distance visual acuity; P > 0.05) (Table 2 ). Table 2 Comparison of surgery-related data between the two groups Samfilcon A group Balafilcon A group Z/t value P value Equivalent spherical refraction(D) -5.53 ± 1.68 -5.51 ± 1.69 0.042 0.967 Theoretical ablation depth(µm) 105.80 ± 26.66 106.96 ± 26.46 0.154 0.878 Corrected distance visual acuity 1.00 ± 0.00 1.00 ± 0.02 1.000 0.317 Subjective scores On the first day postoperatively, the subjective symptom scores between the two groups showed that the samfilcon A group had lower scores than the balafilcon A group (samfilcon A vs. balafilcon A: 8.91 ± 5.57 vs. 9.77 ± 5.55, P = 0.364), but the difference was not statistically significant (P > 0.05). The comparison of OSDI and DEQ-5 scores between the two groups showed no statistically significant differences (P > 0.05) at each visit. The within-group comparison of OSDI and DEQ-5 scores at different time points also showed no statistically significant differences (P > 0.05) (Fig. 1 ). Objective indicators Intergroup comparison On the first day postoperatively, the lens deposit scores in the samfilcon A group were significantly lower than that in the balafilcon A group (P < 0.001) (Fig. 2 A, B). The comparison of uncorrected distance visual acuity, eyelid margin hyperemia scores, conjunctival hyperemia scores, FL scores, SIT, TMH, TBUT, corneal sensitivity, and tear IL-1α and ICAM-1 expression levels between the two groups showed no significant differences at each visit.(P > 0.05) (Fig. 2 C-I, Fig. 3 A, B, Table 3 ). Intragroup comparison The conjunctival hyperemia scores decreased 1 week postoperatively compared with preoperative scores (P = 0.003 and P = 0.004, respectively) in both groups. In the samfilcon A group, the SIT decreased 1 week postoperatively (P = 0.031) and the TBUT decreased 1 day postoperatively (P = 0.031) compared with preoperative levels, with significant differences (P 0.05) for the other time points within each group. In the balafilcon A group, there were no significant differences in SIT and TBUT across the different time points (P > 0.05). There were no significant differences in eyelid margin hyperemia scores, FL scores, TMH, corneal sensitivity, and tear IL-1α and ICAM-1 expression levels across different time points within both groups (P > 0.05) (Figs. 2 C-I, Figs. 3 A, B). Table 3 Postoperative uncorrected distance visual acuity at different time points between the two groups Samfilcon A group Balafilcon A group Z value P value 1 day postoperative 0.98 ± 0.07 0.96 ± 0.10 1.174 0.240 1 week postoperative 1.00 ± 0.00 1.00 ± 0.00 0.000 1.000 1 month postoperative 1.00 ± 0.00 1.00 ± 0.00 0.000 1.000 Discussion Corneal contact lenses were first used in 1998 for patients after corneal refractive surgery. Silicone hydrogel bandage lenses, due to their high oxygen permeability and ability to be worn continuously, have been widely used [ 8 , 9 ]. Numerous studies have shown that early use of silicone hydrogel bandage lenses plays a positive role in promoting corneal epithelial healing after corneal refractive surgery, enhancing tear film stability, and reducing early postoperative discomfort symptoms[ 10 , 11 ]. Additionally, for SMILE postoperative patients, short-term use of silicone hydrogel corneal contact lenses can effectively alleviate postoperative pain and tearing symptoms, thereby improving patient comfort [ 6 ]. In recent years, the materials and processes of silicone hydrogel BCLs have been continuously upgraded and updated. Different types of silicone hydrogel BCLs vary in material, water content, thickness, and oxygen permeability. Studies have shown that using different silicone hydrogel BCLs after corneal refractive surgery has varying effects on patients’ postoperative subjective symptoms[ 12 , 13 ]. However, no studies have compared the differences in subjective symptoms and ocular surface function among SMILE postoperative patients using different BCLs. Therefore, we compared the clinical effects of wearing samfilcon A and balafilcon A after SMILE surgery. Samfilcon A is a new-generation hydrophilic silicone hydrogel lens, which has higher water content and oxygen permeability, thinner central thickness, and lower elastic modulus compared with the first-generation silicone hydrogel lens balafilcon A. Additionally, the samfilcon A lens uses innovative manufacturing techniques to completely encapsulate silicone fibers with polyvinylpyrrolidone wetting agent to attract moisture, making it highly wettable and smooth. In this study, patients wearing samfilcon A lenses had better subjective symptom scores 1 day postoperatively than those wearing balafilcon A lenses, although the difference was not significant. Similarly, Necati Duru et al. found that using samfilcon A silicone hydrogel lenses post-PRK surgery reduced postoperative pain and discomfort symptoms more effectively than balafilcon A silicone hydrogel lenses[ 4 ]. The samfilcon A lenses are smoother, have higher water content, have lower elastic modulus, and are softer, with a thin arcuate edge design that better conforms to the cornea, reducing friction during blinking and alleviating discomfort[ 14 , 15 ]. Compared with balafilcon A lenses, samfilcon A lenses have higher oxygen permeability and thinner central thickness, which facilitate oxygen penetration to the cornea, promoting corneal epithelial healing and improving ocular surface symptoms. However, in our study, there were no significant differences on ocular surface parameters between the two types of BCLs for SMILE postoperative patients. Possible reasons include: 1. SMILE surgery has a minimal impact on ocular surface function, making it difficult to discern differences in postoperative comfort and ocular surface function improvement; 2. Both types of silicone hydrogel lenses have oxygen permeability above 90 DK/t. Studies have reported that when lens oxygen permeability exceeds 90 DK/t, the impact on the ocular surface is minimal [ 16 ]; 3.The advantages of the high oxygen permeability, high water content, and thinner characteristics of the new-generation silicone hydrogel BCLs in terms of corneal protection and safety assessment may be more apparent with prolonged wear. In our study, the lenses were worn for only 1 day, making it difficult to demonstrate the differences. In this study, samfilcon A lenses demonstrated superior resistance to deposits compared with balafilcon A lenses, which may be related to the material of the lenses. Protein deposits have long been considered a major factor in reducing oxygen permeability of lenses and causing various complications associated with lens wear. The primary materials of new silicone hydrogel contact lenses, such as siloxane hydrogel and fluorosiloxane hydrogel, combine the high oxygen permeability and low protein adsorption of silicone materials with the softness of traditional hydrogel lenses[ 17 ]. The limitations of this study include the subjective evaluation of lens deposits without using quantitative methods such as protein and lipid deposition measurements, which prevents a precise comparison of deposit amounts. This aspect needs improvement in future research. The strength of this study lies in its use of a self-controlled design, comparing the two commonly used silicone hydrogel corneal contact lenses post-SMILE surgery in terms of subjective symptoms, ocular surface function, and vision, thereby providing a reference for the rational selection of BCLs. In conclusion, we believe that both samfilcon A and balafilcon A silicone hydrogel corneal contact lenses are safe. Samfilcon A lenses perform better in resisting deposits, but there is no significant difference between the two in improving ocular surface changes caused by SMILE surgery. Abbreviations BCL bandage contact lens TBUT tear breakup time DEQ-5 5-Item Dry Eye Questionnaire FL fluorescein staining ICAM-1 intercellular adhesion molecule-1 IL-1α interleukin-1α OSDI Ocular Surface Disease Index SIT Schirmer I test SMILE small incision lenticule extraction TMH tear meniscus height Declarations Ethics approval and consent to participate This study followed the principles of the Declaration of Helsinki and was approved by the Ethics Committee of Hainan Eye Hospital (Approval No. 2024-001-01). The trial registration number was ChiCTR2400083482. All patients were informed and signed an informed consent form. Consent for publication All authors consent to publication. Availability of data and material Data are available from the corresponding author on reasonable request. Competing interests XZ, none; SH, none; HD, none; XC, none; LS, none; ZY, none. Funding This work was supported by grants from Nanhai Junior Talent Program of Hainan Provincial Health Commission (NHXX-WJW-2023020), Hainan Provincial Natural Science Foundation of China (820MS152), Science and Technology Planning Project of Hainan Province (ZDYF2022SHFZ326, LCYX202406), and Hainan Province Clinical Medical Center. Authors’ contributions The study was designed by XZ and SH. Material preparation and data collection were performed by SH, XC, ZY, and LS. Data analysis was performed by SH. The manuscript was written by SH, and reviewed and edited by XZ and HD. All authors read and approved the final manuscript. Acknowledgments Editorial support was provided by Lydia Jennings (Illuminate Medical Ltd., UK) and funded by Bausch + Lomb, Inc. References Sekundo W, Kunert KS, Blum M. 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Sánchez-González JM, Gargallo-Martínez B, De-Hita-Cantalejo C, Bautista-Llamas MJ. Bandage contact lens use after photorefractive keratectomy: updated review. J Cataract Refract Surg. 2022;48(6):741-2. Duru Z, Duru N, Ulusoy DM. Effects of senofilcon A and lotrafilcon B bandage contact lenses on epithelial healing and pain management after bilateral photorefractive keratectomy. Cont Lens Anterior Eye. 2020;43(2):169-72. Mohammadpour M, Amouzegar A, Hashemi H, Jabbarvand M, Kordbacheh H, Rahimi F, Hashemian MN. Comparison of Lotrafilcon B and Balafilcon A silicone hydrogel bandage contact lenses in reducing pain and discomfort after photorefractive keratectomy: A contralateral eye study. Cont Lens Anterior Eye. 2015;38(3):211-14. Akcam HT, Unlu M, Karaca EE, Yazici H, Aydin B, Hondur AM. Autologous serum eye-drops and enhanced epithelial healing time after photorefractive keratectomy. Clin Exp Optom 2018;101(1):34-7. Jacobs DS, Carrasquillo KG, Cottrell PD, Fernández-Velázquez FJ, Gil-Cazorla R, Jalbert I, et al. BCLA CLEAR - Medical use of contact lenses. Cont Lens Anterior Eye 2021;44(2):289-329. Bagherian H, Zarei-Ghanavati S, Momeni-Moghaddam H, Wolffsohn JS, Sedaghat MR, Naroo SA, Monfared N. Masked comparison of two silicone hydrogel bandage contact lenses after photorefractive keratectomy. Cont Lens Anterior Eye. 2020;43(3):244-9. Sulley A, Dumbleton K. Silicone hydrogel daily disposable benefits: The evidence. Cont Lens Anterior Eye. 2020;43(3):298-307. Additional Declarations No competing interests reported. Cite Share Download PDF Status: Published Journal Publication published 27 Oct, 2025 Read the published version in BMC Research Notes → Version 1 posted Editorial decision: Revision requested 12 Nov, 2024 Editor assigned by journal 08 Nov, 2024 Submission checks completed at journal 08 Nov, 2024 First submitted to journal 07 Nov, 2024 You are reading this latest preprint version Research Square lets you share your work early, gain feedback from the community, and start making changes to your manuscript prior to peer review in a journal. As a division of Research Square Company, we’re committed to making research communication faster, fairer, and more useful. We do this by developing innovative software and high quality services for the global research community. Our growing team is made up of researchers and industry professionals working together to solve the most critical problems facing scientific publishing. Also discoverable on Platform About Our Team In Review Editorial Policies Advisory Board Help Center Resources Author Services Accessibility API Access RSS feed Manage Cookie Preferences © Research Square 2026 | ISSN 2693-5015 (online) Privacy Policy Terms of Service Do Not Sell My Personal Information {"props":{"pageProps":{"initialData":{"identity":"rs-5407465","acceptedTermsAndConditions":true,"allowDirectSubmit":false,"archivedVersions":[],"articleType":"Short Report","associatedPublications":[],"authors":[{"id":379971440,"identity":"20bf5443-ee77-4dcb-a9c7-f8b119c515b6","order_by":0,"name":"Shisi Hu","email":"","orcid":"","institution":"Hainan Eye Hospital, Sun Yat-sen University","correspondingAuthor":false,"prefix":"","firstName":"Shisi","middleName":"","lastName":"Hu","suffix":""},{"id":379971441,"identity":"39c42b49-872d-491a-97fe-125361ee7380","order_by":1,"name":"Hui Ding","email":"","orcid":"","institution":"Hainan Eye Hospital, Sun Yat-sen University","correspondingAuthor":false,"prefix":"","firstName":"Hui","middleName":"","lastName":"Ding","suffix":""},{"id":379971442,"identity":"4a38c1e7-408e-461c-9adf-c5a7578c97ac","order_by":2,"name":"Xiaodan Chen","email":"","orcid":"","institution":"Hainan Eye Hospital, Sun Yat-sen University","correspondingAuthor":false,"prefix":"","firstName":"Xiaodan","middleName":"","lastName":"Chen","suffix":""},{"id":379971444,"identity":"003b8ca7-7077-49d6-8bc9-d707a3d1dfa1","order_by":3,"name":"Shanxiang Li","email":"","orcid":"","institution":"Hainan Eye Hospital, Sun Yat-sen University","correspondingAuthor":false,"prefix":"","firstName":"Shanxiang","middleName":"","lastName":"Li","suffix":""},{"id":379971446,"identity":"d8f3fb60-440b-423d-97b3-0c1c6e40e704","order_by":4,"name":"Zhenduo Yang","email":"","orcid":"","institution":"Hainan Eye Hospital, Sun Yat-sen University","correspondingAuthor":false,"prefix":"","firstName":"Zhenduo","middleName":"","lastName":"Yang","suffix":""},{"id":379971448,"identity":"ef98e8c4-d70a-473e-85db-7390d1c6eccd","order_by":5,"name":"Xingwu Zhong","email":"data:image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAZAAAAAyAQMAAABI0h/eAAAABlBMVEX///8AAABVwtN+AAAACXBIWXMAAA7EAAAOxAGVKw4bAAABC0lEQVRIiWNgGAWjYDACCSjND8QHHsBEeYjRItkA1JJAkhaDA0CCKC3ys5uPPfzadjhx87XDD4G21CXOn5HA+OBtG4O8OQ4tjHOOpRvLnDmcuO12mgFQy+HEDTcSmA3ntjEY7mzAroVZIsdMWqLiNlBLAkjLgcQNEgls0rxtDAlgp2IBbGAtBrcTN89O/wBzGPtvfFp4gFokPwBt2SCdA7KFObHhRgIbMz4tEhJpadIMZ/4bz7idU3AgweCw8YYzD5sl55yTMNyAQ4v8jORjkj/b0mT7Z6dv/vChok52fnvywQ9vymzkcdkCDgJELBgwODYwMDYwIOILO2D8gcSxx6t0FIyCUTAKRiQAAGlLYKVC3pjtAAAAAElFTkSuQmCC","orcid":"","institution":"Hainan Eye Hospital, Sun Yat-sen University","correspondingAuthor":true,"prefix":"","firstName":"Xingwu","middleName":"","lastName":"Zhong","suffix":""}],"badges":[],"createdAt":"2024-11-07 07:08:18","currentVersionCode":1,"declarations":"","doi":"10.21203/rs.3.rs-5407465/v1","doiUrl":"https://doi.org/10.21203/rs.3.rs-5407465/v1","draftVersion":[],"editorialEvents":[{"content":"https://doi.org/10.1186/s13104-025-07304-1","type":"published","date":"2025-10-27T15:58:16+00:00"}],"editorialNote":"","failedWorkflow":false,"files":[{"id":71138092,"identity":"bf074c36-045c-4795-8b53-739b1b569916","added_by":"auto","created_at":"2024-12-11 13:27:18","extension":"png","order_by":1,"title":"Figure 1","display":"","copyAsset":false,"role":"figure","size":69674,"visible":true,"origin":"","legend":"\u003cp\u003eComparison of preoperative and postoperative subjective scores between the balafilcon A group and samfilcon A group\u003c/p\u003e\n\u003cp\u003eA. Subjective symptomscores\u003c/p\u003e\n\u003cp\u003eB. OSDI scores\u003c/p\u003e\n\u003cp\u003eC. DEQ-5 scores\u003c/p\u003e\n\u003cp\u003eDEQ-5, 5-Item Dry Eye Questionnaire; OSDI, Ocular Surface Disease Index\u003c/p\u003e","description":"","filename":"1.png","url":"https://assets-eu.researchsquare.com/files/rs-5407465/v1/a9134aad933e977d678bafb1.png"},{"id":71138094,"identity":"6cf635e0-54de-4fe2-a48a-e019436d345e","added_by":"auto","created_at":"2024-12-11 13:27:18","extension":"png","order_by":2,"title":"Figure 2","display":"","copyAsset":false,"role":"figure","size":233614,"visible":true,"origin":"","legend":"\u003cp\u003eComparison of objective indicators between the balafilcon A group and samfilcon A group\u003c/p\u003e\n\u003cp\u003eA. Diagram of lens deposits scores\u003c/p\u003e\n\u003cp\u003eB. Lens deposits scores\u003c/p\u003e\n\u003cp\u003eC. Corneal sensitivity\u003c/p\u003e\n\u003cp\u003eD. Eyelid margin hyperemia scores\u003c/p\u003e\n\u003cp\u003eE. Conjunctival hyperemia scores\u003c/p\u003e\n\u003cp\u003eF. Tear breakup time (TBUT)\u003c/p\u003e\n\u003cp\u003eG. Corneal fluorescein staining (FL) scores\u003c/p\u003e\n\u003cp\u003eH. TMH\u003c/p\u003e\n\u003cp\u003eI. Schirmer I test (SIT)\u003c/p\u003e\n\u003cp\u003eComparisons between the two groups: *** indicates P\u0026lt;0.001; “a” indicates comparison with preoperative values, P\u0026lt;0.05.\u003c/p\u003e\n\u003cp\u003eTBUT, tear breakup time; FL, fluorescein staining; TMH, tear meniscus height.\u003c/p\u003e","description":"","filename":"2.png","url":"https://assets-eu.researchsquare.com/files/rs-5407465/v1/458b8eeaf2cb889a145a340a.png"},{"id":71138812,"identity":"ef5d1f47-aa20-4398-8f5d-41223f9719a7","added_by":"auto","created_at":"2024-12-11 13:35:18","extension":"png","order_by":3,"title":"Figure 3","display":"","copyAsset":false,"role":"figure","size":51645,"visible":true,"origin":"","legend":"\u003cp\u003eComparison of tear inflammation-related indicators between the balafilcon A group and samfilcon A group\u003c/p\u003e\n\u003cp\u003eA. IL-1α\u003c/p\u003e\n\u003cp\u003eB. ICAM-1\u003c/p\u003e\n\u003cp\u003eICAM-1, intercellular adhesion molecule-1; IL-1α, interleukin-1α.\u003c/p\u003e","description":"","filename":"3.png","url":"https://assets-eu.researchsquare.com/files/rs-5407465/v1/3ac495016b5db705b57b4c37.png"},{"id":95041275,"identity":"f00a194b-b672-4198-9135-43dd22b06fab","added_by":"auto","created_at":"2025-11-03 16:11:03","extension":"pdf","order_by":0,"title":"","display":"","copyAsset":false,"role":"manuscript-pdf","size":919862,"visible":true,"origin":"","legend":"","description":"","filename":"manuscript.pdf","url":"https://assets-eu.researchsquare.com/files/rs-5407465/v1/ca3f511f-2d29-426f-a26e-25586b132e29.pdf"}],"financialInterests":"No competing interests reported.","formattedTitle":"Clinical Observation of Early Postoperative Wear of Balafilcon A and Innovative First-Generation Samfilcon A Silicone Hydrogel Bandage Contact Lenses after SMILE Surgery","fulltext":[{"header":"Introduction","content":"\u003cp\u003eIn recent years, small incision lenticule extraction (SMILE) has become a mainstream refractive correction surgery due to its advantages in effectiveness, safety, and stability [\u003cspan citationid=\"CR1\" class=\"CitationRef\"\u003e1\u003c/span\u003e, \u003cspan citationid=\"CR2\" class=\"CitationRef\"\u003e2\u003c/span\u003e]. However, in the early postoperative period, some patients still report discomfort symptoms such as foreign body sensation, pain, and dry eyes.\u003c/p\u003e \u003cp\u003eBandage contact lenses (BCLs) are often used to promote corneal wound healing after refractive surgery and to alleviate postoperative irritation symptoms [\u003cspan additionalcitationids=\"CR4\" citationid=\"CR3\" class=\"CitationRef\"\u003e3\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR5\" class=\"CitationRef\"\u003e5\u003c/span\u003e]. Studies have shown that early postoperative wear of silicone hydrogel BCLs after SMILE surgery can improve subjective discomfort symptoms, enhance overall patient comfort, and reduce corneal edema [\u003cspan citationid=\"CR6\" class=\"CitationRef\"\u003e6\u003c/span\u003e]. Balafilcon A and samfilcon A are two types of silicone hydrogel BCLs made from different materials and design processes. The innovative first-generation samfilcon A silicone hydrogel bandage lens has superior properties in terms of oxygen permeability, water content, and thickness. This study prospectively observes the clinical effects of wearing two different silicone hydrogel BCLs in the early postoperative period after SMILE surgery, comparing their effects on postoperative comfort and ocular surface function, providing reliable reference for the selection of postoperative BCLs.\u003c/p\u003e"},{"header":"Materials and methods","content":"\u003cdiv id=\"Sec3\" class=\"Section2\"\u003e \u003ch2\u003eGeneral information\u003c/h2\u003e \u003cp\u003eTwenty-five cases (50 eyes) of patients with refractive error who underwent bilateral SMILE surgery in May 2023 at Hainan Eye Hospital were observed. Among them were 13 females and 12 males, with an average age of 25.72\u0026thinsp;\u0026plusmn;\u0026thinsp;4.64 years. This is a prospective, randomized, double-blind, self-controlled study, following the principles of the Declaration of Helsinki, and was approved by the Ethics Committee of Hainan Eye Hospital. All patients were informed and signed an informed consent form.\u003c/p\u003e \u003c/div\u003e\n\u003ch3\u003eInclusion criteria\u003c/h3\u003e\n\u003cp\u003e(1) Age\u0026thinsp;\u0026ge;\u0026thinsp;18 years; (2) Best corrected visual acuity\u0026thinsp;\u0026ge;\u0026thinsp;1.0; (3) Spherical power \u0026ge;-8.00 D, cylindrical power\u0026thinsp;\u0026le;\u0026thinsp;3.00 D.\u003c/p\u003e\n\u003ch3\u003eExclusion criteria\u003c/h3\u003e\n\u003cp\u003e(1) Eye parameters not meeting surgical requirements, presence of anterior or posterior segment diseases, or active inflammation affecting surgery; (2) Presence of systemic diseases that may affect postoperative vision or delay healing; (3) Pregnant or lactating women.\u003c/p\u003e\n\u003ch3\u003eSurgical method\u003c/h3\u003e\n\u003cp\u003eThe surgery was performed using the German ZEISS VisuMax femtosecond laser system, with all surgeries completed by the same surgeon. All patients received surface anesthesia with 0.5% proparacaine hydrochloride eye drops. The parameters were set as follows: lenticule diameter of 6.0\u0026ndash;6.5 mm, cap thickness of 110\u0026ndash;120 \u0026micro;m, cap diameter of 7.5 mm, and lenticule incision of 2 mm. After completing the femtosecond laser scan, the laser-cut stromal lenticule was removed through the lenticule incision. Finally, the corneal stromal bed was thoroughly rinsed with a balanced solution. After the surgery, another physician, according to a random number table, provided the corresponding BCLs to the surgeon. One eye was fitted with balafilcon A (Pure Vision, Bausch \u0026amp; Lomb, USA) and the other eye was fitted with samfilcon A (ULTRA, Bausch \u0026amp; Lomb, USA) (Table\u0026nbsp;\u003cspan refid=\"Tab1\" class=\"InternalRef\"\u003e1\u003c/span\u003e). Neither the surgeon nor the patients were aware of the eye assignments for the two types of BCLs. The physician who assigned the BCLs did not participate in the subsequent treatment and examinations of the patients. The BCLs were removed from both eyes on the first postoperative day.\u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab1\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 1\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003eComparison of parameters for two types of corneal contact lenses\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"3\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\"\u003e \u003cp\u003eBrand\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003eSamfilcon A group\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003eBalafilcon A group\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eWater content\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e46%\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e36%\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eOxygen permeability (DK/t)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e137\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e101\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eElastic modulus (mPa)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e0.69\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e1.1\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eCentral thickness (mm)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e0.07\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e0.09\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eLens diameter (mm)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e14.2\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e14.0\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eBase curve (mm)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e8.5\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e8.6\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e\n\u003ch3\u003ePreoperative and postoperative medication\u003c/h3\u003e\n\u003cp\u003ePreoperatively, 0.5% levofloxacin eye drops were used four times a day for 3 days. Postoperatively, 0.5% levofloxacin eye drops were used four times a day for 7 days; 0.3% tobramycin dexamethasone eye drops were used four times a day for 3 days; 0.5% loteprednol etabonate suspension eye drops were used four times a day from the fourth day aftter surgery to the fourteenth day; and 0.1% sodium hyaluronate eye drops were used four times a day for 30 days.\u003c/p\u003e \u003cdiv id=\"Sec8\" class=\"Section2\"\u003e \u003ch2\u003eEvaluation indicators\u003c/h2\u003e \u003cp\u003eThe examining physician removed the BCLs 1 day postoperatively and evaluated the surface deposits on the lens. The BCLs is divided into five areas: upper, lower, nasal, temporal, and central. The score range from 0 to 3 is based on the density of the surface deposits on the lens. A score of 0 indicates no protein deposits and 3 indicates dense protein deposits. The sum of the scores for each area is calculated. Then patients were immediately asked to score their subjective ocular symptoms, including stinging sensation, foreign body sensation, and tearing. Each symptom is scored separately, with 0 indicating no discomfort and 10 indicating the highest degree of discomfort.\u003c/p\u003e \u003cp\u003eVisual acuity, Ocular Surface Disease Index (OSDI), 5-Item Dry Eye Questionnaire (DEQ-5) scores, eyelid margin hyperemia scores, conjunctival hyperemia scores, tear breakup time (TBUT), fluorescein staining (FL) scores, tear meniscus height (TMH), corneal sensitivity measurements, basic tear secretion test (Schirmer I test [SIT]) and tear inflammatory mediators were assessed preoperatively and at 1 day, 1 week, and 1 month postoperatively. ①Patients answer the questionnaires based on their own conditions, and the scores of OSDI and DEQ-5 are verified and recorded. ②TBUT and SIT were evaluated on all participants as described[\u003cspan citationid=\"CR7\" class=\"CitationRef\"\u003e7\u003c/span\u003e]. ③The score of eyelid margin hyperemia is assessed as follows: 0: normal color; 1: the involvement of pinkish capillaries; 2: deep pink or red confluent capillaries in localized areas; 3: deep red, diffuse, confluent capillaries. ④The score of conjunctival hyperemia is assessed as follows: 0 : no vessel dilation; 1 : occasional vessel dilation in the fornix; 2: mild hyperemia with slightly blurred vessel outlines; 3: moderate hyperemia approaching the limbus with tortuous vessels; 4: severe hyperemia involving the entire bulbar conjunctiva with indistinct vessel pathways. ⑤The corneal fluorescein staining is observed under cobalt blue light in a slit-lamp microscope and scored in upper, lower, nasal, temporal, and central areas of cornea as follows: 0: no staining; 1༚less than 15 points of staining; 2༚16\u0026ndash;30 points of staining; 3: more than 30 points of staining or the presence of confluent staining. The sum of the scores for each area is calculated. ⑥TMH is measured three times using the Gaush iDea ocular surface interferometer and the average value is recorded. ⑦Corneal sensitivity is measured in the upper, lower, central, nasal, and temporal areas using a Cochet-Bonnet esthesiometer. The measurement starts at 60 mm; if there is no sensation, it is decreased by 5 mm increments until the patient feels the filament. The average value of each area is calculated. ⑧Tear samples were also collected to detect the expression of interleukin-1α (IL-1α) and intercellular adhesion molecule-1 (ICAM-1). Tear samples are collected for RNA extraction. Reverse transcription and real-time quantitative polymerase chain reaction detection are performed according to the instructions of the Reverse Transcriptase M-MLV (RNase H-) kit (TAKARA, Japan). Based on the Ct values of each gene, the comparative delta-delta Ct method is used: △△Ct = (Ct gene - Ct reference gene) - (Ct gene - Ct reference gene control group), and the relative expression levels of each gene compared with the control group are calculated using the 2\u003csup\u003e^\u0026minus;△△CT\u003c/sup\u003e formula.\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec9\" class=\"Section2\"\u003e \u003ch2\u003eStatistical analysis\u003c/h2\u003e \u003cp\u003e \u003cdiv class=\"BlockQuote\"\u003e \u003cp\u003eData analysis was performed using SPSS 27.0 software. The Kolmogorov\u0026ndash;Smirnov test was used to check the normality of the measurement data. For normally distributed data, the independent sample t-test was used for intergroup comparisons; for non-normally distributed data, the Wilcoxon rank-sum test was used. Repeated measures analysis of variance was used to compare different time points for repeated measurement data, with post hoc pairwise comparisons performed using the least significant difference t-test. For repeated measurement data that did not meet the requirements for analysis of variance, the generalized linear model was used for comparison across different time points, and post hoc pairwise comparisons were adjusted for significance using the Bonferroni method. Data are presented as mean\u0026thinsp;\u0026plusmn;\u0026thinsp;standard deviation, and P\u0026thinsp;\u0026lt;\u0026thinsp;0.05 was considered statistically significant.\u003c/p\u003e \u003c/div\u003e \u003c/p\u003e \u003c/div\u003e"},{"header":"Results","content":"\u003cp\u003eThere were no statistically significant differences between the two groups in preoperative equivalent spherical refraction, theoretical ablation depth, and preoperative best corrected visual acuity (corrected distance visual acuity; P\u0026thinsp;\u0026gt;\u0026thinsp;0.05) (Table\u0026nbsp;\u003cspan refid=\"Tab2\" class=\"InternalRef\"\u003e2\u003c/span\u003e).\u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab2\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 2\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003eComparison of surgery-related data between the two groups\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"5\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\"\u0026plusmn;\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\"\u0026plusmn;\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c5\" colnum=\"5\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/th\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003eSamfilcon A group\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003eBalafilcon A group\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c4\"\u003e \u003cp\u003eZ/t value\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c5\"\u003e \u003cp\u003eP value\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eEquivalent spherical refraction(D)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c2\"\u003e \u003cp\u003e-5.53\u0026thinsp;\u0026plusmn;\u0026thinsp;1.68\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c3\"\u003e \u003cp\u003e-5.51\u0026thinsp;\u0026plusmn;\u0026thinsp;1.69\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0.042\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e0.967\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eTheoretical ablation depth(\u0026micro;m)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c2\"\u003e \u003cp\u003e105.80\u0026thinsp;\u0026plusmn;\u0026thinsp;26.66\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c3\"\u003e \u003cp\u003e106.96\u0026thinsp;\u0026plusmn;\u0026thinsp;26.46\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0.154\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e0.878\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eCorrected distance visual acuity\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c2\"\u003e \u003cp\u003e1.00\u0026thinsp;\u0026plusmn;\u0026thinsp;0.00\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c3\"\u003e \u003cp\u003e1.00\u0026thinsp;\u0026plusmn;\u0026thinsp;0.02\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e1.000\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e0.317\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003cdiv id=\"Sec11\" class=\"Section2\"\u003e \u003ch2\u003eSubjective scores\u003c/h2\u003e \u003cp\u003eOn the first day postoperatively, the subjective symptom scores between the two groups showed that the samfilcon A group had lower scores than the balafilcon A group (samfilcon A vs. balafilcon A: 8.91\u0026thinsp;\u0026plusmn;\u0026thinsp;5.57 vs. 9.77\u0026thinsp;\u0026plusmn;\u0026thinsp;5.55, P\u0026thinsp;=\u0026thinsp;0.364), but the difference was not statistically significant (P\u0026thinsp;\u0026gt;\u0026thinsp;0.05). The comparison of OSDI and DEQ-5 scores between the two groups showed no statistically significant differences (P\u0026thinsp;\u0026gt;\u0026thinsp;0.05) at each visit. The within-group comparison of OSDI and DEQ-5 scores at different time points also showed no statistically significant differences (P\u0026thinsp;\u0026gt;\u0026thinsp;0.05) (Fig.\u0026nbsp;\u003cspan refid=\"Fig1\" class=\"InternalRef\"\u003e1\u003c/span\u003e).\u003c/p\u003e \u003cp\u003e \u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec12\" class=\"Section2\"\u003e \u003ch2\u003eObjective indicators\u003c/h2\u003e \u003cdiv id=\"Sec13\" class=\"Section3\"\u003e \u003ch2\u003eIntergroup comparison\u003c/h2\u003e \u003cp\u003eOn the first day postoperatively, the lens deposit scores in the samfilcon A group were significantly lower than that in the balafilcon A group (P\u0026thinsp;\u0026lt;\u0026thinsp;0.001) (Fig.\u0026nbsp;\u003cspan refid=\"Fig2\" class=\"InternalRef\"\u003e2\u003c/span\u003eA, B).\u003c/p\u003e \u003cp\u003e \u003c/p\u003e \u003cp\u003eThe comparison of uncorrected distance visual acuity, eyelid margin hyperemia scores, conjunctival hyperemia scores, FL scores, SIT, TMH, TBUT, corneal sensitivity, and tear IL-1α and ICAM-1 expression levels between the two groups showed no significant differences at each visit.(P\u0026thinsp;\u0026gt;\u0026thinsp;0.05) (Fig.\u0026nbsp;\u003cspan refid=\"Fig2\" class=\"InternalRef\"\u003e2\u003c/span\u003eC-I, Fig.\u0026nbsp;\u003cspan refid=\"Fig3\" class=\"InternalRef\"\u003e3\u003c/span\u003eA, B, Table\u0026nbsp;\u003cspan refid=\"Tab3\" class=\"InternalRef\"\u003e3\u003c/span\u003e).\u003c/p\u003e \u003cp\u003e \u003c/p\u003e \u003c/div\u003e \u003c/div\u003e \u003cdiv id=\"Sec14\" class=\"Section2\"\u003e \u003ch2\u003eIntragroup comparison\u003c/h2\u003e \u003cp\u003eThe conjunctival hyperemia scores decreased 1 week postoperatively compared with preoperative scores (P\u0026thinsp;=\u0026thinsp;0.003 and P\u0026thinsp;=\u0026thinsp;0.004, respectively) in both groups. In the samfilcon A group, the SIT decreased 1 week postoperatively (P\u0026thinsp;=\u0026thinsp;0.031) and the TBUT decreased 1 day postoperatively (P\u0026thinsp;=\u0026thinsp;0.031) compared with preoperative levels, with significant differences (P\u0026thinsp;\u0026lt;\u0026thinsp;0.05). There were no significant differences (P\u0026thinsp;\u0026gt;\u0026thinsp;0.05) for the other time points within each group.\u003c/p\u003e \u003cp\u003eIn the balafilcon A group, there were no significant differences in SIT and TBUT across the different time points (P\u0026thinsp;\u0026gt;\u0026thinsp;0.05). There were no significant differences in eyelid margin hyperemia scores, FL scores, TMH, corneal sensitivity, and tear IL-1α and ICAM-1 expression levels across different time points within both groups (P\u0026thinsp;\u0026gt;\u0026thinsp;0.05) (Figs.\u0026nbsp;\u003cspan refid=\"Fig2\" class=\"InternalRef\"\u003e2\u003c/span\u003eC-I, Figs.\u0026nbsp;\u003cspan refid=\"Fig3\" class=\"InternalRef\"\u003e3\u003c/span\u003eA, B).\u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab3\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 3\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003ePostoperative uncorrected distance visual acuity at different time points between the two groups\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"5\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\"\u0026plusmn;\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\"\u0026plusmn;\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c5\" colnum=\"5\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/th\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003eSamfilcon A\u003c/p\u003e \u003cp\u003egroup\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003eBalafilcon A group\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c4\"\u003e \u003cp\u003eZ value\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c5\"\u003e \u003cp\u003eP value\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e1 day postoperative\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c2\"\u003e \u003cp\u003e0.98\u0026thinsp;\u0026plusmn;\u0026thinsp;0.07\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c3\"\u003e \u003cp\u003e0.96\u0026thinsp;\u0026plusmn;\u0026thinsp;0.10\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e1.174\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e0.240\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e1 week postoperative\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c2\"\u003e \u003cp\u003e1.00\u0026thinsp;\u0026plusmn;\u0026thinsp;0.00\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c3\"\u003e \u003cp\u003e1.00\u0026thinsp;\u0026plusmn;\u0026thinsp;0.00\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0.000\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e1.000\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e1 month postoperative\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c2\"\u003e \u003cp\u003e1.00\u0026thinsp;\u0026plusmn;\u0026thinsp;0.00\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c3\"\u003e \u003cp\u003e1.00\u0026thinsp;\u0026plusmn;\u0026thinsp;0.00\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0.000\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e1.000\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003c/div\u003e"},{"header":"Discussion","content":"\u003cp\u003eCorneal contact lenses were first used in 1998 for patients after corneal refractive surgery. Silicone hydrogel bandage lenses, due to their high oxygen permeability and ability to be worn continuously, have been widely used [\u003cspan citationid=\"CR8\" class=\"CitationRef\"\u003e8\u003c/span\u003e, \u003cspan citationid=\"CR9\" class=\"CitationRef\"\u003e9\u003c/span\u003e]. Numerous studies have shown that early use of silicone hydrogel bandage lenses plays a positive role in promoting corneal epithelial healing after corneal refractive surgery, enhancing tear film stability, and reducing early postoperative discomfort symptoms[\u003cspan citationid=\"CR10\" class=\"CitationRef\"\u003e10\u003c/span\u003e, \u003cspan citationid=\"CR11\" class=\"CitationRef\"\u003e11\u003c/span\u003e]. Additionally, for SMILE postoperative patients, short-term use of silicone hydrogel corneal contact lenses can effectively alleviate postoperative pain and tearing symptoms, thereby improving patient comfort [\u003cspan citationid=\"CR6\" class=\"CitationRef\"\u003e6\u003c/span\u003e].\u003c/p\u003e \u003cp\u003eIn recent years, the materials and processes of silicone hydrogel BCLs have been continuously upgraded and updated. Different types of silicone hydrogel BCLs vary in material, water content, thickness, and oxygen permeability. Studies have shown that using different silicone hydrogel BCLs after corneal refractive surgery has varying effects on patients\u0026rsquo; postoperative subjective symptoms[\u003cspan citationid=\"CR12\" class=\"CitationRef\"\u003e12\u003c/span\u003e, \u003cspan citationid=\"CR13\" class=\"CitationRef\"\u003e13\u003c/span\u003e]. However, no studies have compared the differences in subjective symptoms and ocular surface function among SMILE postoperative patients using different BCLs.\u003c/p\u003e \u003cp\u003eTherefore, we compared the clinical effects of wearing samfilcon A and balafilcon A after SMILE surgery. Samfilcon A is a new-generation hydrophilic silicone hydrogel lens, which has higher water content and oxygen permeability, thinner central thickness, and lower elastic modulus compared with the first-generation silicone hydrogel lens balafilcon A. Additionally, the samfilcon A lens uses innovative manufacturing techniques to completely encapsulate silicone fibers with polyvinylpyrrolidone wetting agent to attract moisture, making it highly wettable and smooth.\u003c/p\u003e \u003cp\u003eIn this study, patients wearing samfilcon A lenses had better subjective symptom scores 1 day postoperatively than those wearing balafilcon A lenses, although the difference was not significant. Similarly, Necati Duru et al. found that using samfilcon A silicone hydrogel lenses post-PRK surgery reduced postoperative pain and discomfort symptoms more effectively than balafilcon A silicone hydrogel lenses[\u003cspan citationid=\"CR4\" class=\"CitationRef\"\u003e4\u003c/span\u003e]. The samfilcon A lenses are smoother, have higher water content, have lower elastic modulus, and are softer, with a thin arcuate edge design that better conforms to the cornea, reducing friction during blinking and alleviating discomfort[\u003cspan citationid=\"CR14\" class=\"CitationRef\"\u003e14\u003c/span\u003e, \u003cspan citationid=\"CR15\" class=\"CitationRef\"\u003e15\u003c/span\u003e].\u003c/p\u003e \u003cp\u003eCompared with balafilcon A lenses, samfilcon A lenses have higher oxygen permeability and thinner central thickness, which facilitate oxygen penetration to the cornea, promoting corneal epithelial healing and improving ocular surface symptoms. However, in our study, there were no significant differences on ocular surface parameters between the two types of BCLs for SMILE postoperative patients. Possible reasons include: 1. SMILE surgery has a minimal impact on ocular surface function, making it difficult to discern differences in postoperative comfort and ocular surface function improvement; 2. Both types of silicone hydrogel lenses have oxygen permeability above 90 DK/t. Studies have reported that when lens oxygen permeability exceeds 90 DK/t, the impact on the ocular surface is minimal [\u003cspan citationid=\"CR16\" class=\"CitationRef\"\u003e16\u003c/span\u003e]; 3.The advantages of the high oxygen permeability, high water content, and thinner characteristics of the new-generation silicone hydrogel BCLs in terms of corneal protection and safety assessment may be more apparent with prolonged wear. In our study, the lenses were worn for only 1 day, making it difficult to demonstrate the differences.\u003c/p\u003e \u003cp\u003eIn this study, samfilcon A lenses demonstrated superior resistance to deposits compared with balafilcon A lenses, which may be related to the material of the lenses. Protein deposits have long been considered a major factor in reducing oxygen permeability of lenses and causing various complications associated with lens wear. The primary materials of new silicone hydrogel contact lenses, such as siloxane hydrogel and fluorosiloxane hydrogel, combine the high oxygen permeability and low protein adsorption of silicone materials with the softness of traditional hydrogel lenses[\u003cspan citationid=\"CR17\" class=\"CitationRef\"\u003e17\u003c/span\u003e].\u003c/p\u003e \u003cp\u003eThe limitations of this study include the subjective evaluation of lens deposits without using quantitative methods such as protein and lipid deposition measurements, which prevents a precise comparison of deposit amounts. This aspect needs improvement in future research. The strength of this study lies in its use of a self-controlled design, comparing the two commonly used silicone hydrogel corneal contact lenses post-SMILE surgery in terms of subjective symptoms, ocular surface function, and vision, thereby providing a reference for the rational selection of BCLs.\u003c/p\u003e \u003cp\u003eIn conclusion, we believe that both samfilcon A and balafilcon A silicone hydrogel corneal contact lenses are safe. Samfilcon A lenses perform better in resisting deposits, but there is no significant difference between the two in improving ocular surface changes caused by SMILE surgery.\u003c/p\u003e"},{"header":"Abbreviations","content":"\u003ctable border=\"0\" cellspacing=\"0\" cellpadding=\"0\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 22.3529%;\"\u003e\n \u003cp\u003eBCL\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 77.6471%;\"\u003e\n \u003cp\u003ebandage contact lens\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 22.3529%;\"\u003e\n \u003cp\u003eTBUT\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 77.6471%;\"\u003e\n \u003cp\u003etear breakup time\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 22.3529%;\"\u003e\n \u003cp\u003eDEQ-5\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 77.6471%;\"\u003e\n \u003cp\u003e5-Item Dry Eye Questionnaire\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 22.3529%;\"\u003e\n \u003cp\u003eFL\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 77.6471%;\"\u003e\n \u003cp\u003efluorescein staining\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 22.3529%;\"\u003e\n \u003cp\u003eICAM-1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 77.6471%;\"\u003e\n \u003cp\u003eintercellular adhesion molecule-1\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 22.3529%;\"\u003e\n \u003cp\u003eIL-1\u0026alpha;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 77.6471%;\"\u003e\n \u003cp\u003einterleukin-1\u0026alpha;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 22.3529%;\"\u003e\n \u003cp\u003eOSDI\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 77.6471%;\"\u003e\n \u003cp\u003eOcular Surface Disease Index\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 22.3529%;\"\u003e\n \u003cp\u003eSIT\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 77.6471%;\"\u003e\n \u003cp\u003eSchirmer I test\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 22.3529%;\"\u003e\n \u003cp\u003eSMILE\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 77.6471%;\"\u003e\n \u003cp\u003esmall incision lenticule extraction\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 22.3529%;\"\u003e\n \u003cp\u003eTMH\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 77.6471%;\"\u003e\n \u003cp\u003etear meniscus height\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e"},{"header":"Declarations","content":"\u003cp\u003eEthics approval and consent to participate\u003c/p\u003e\n\u003cp\u003eThis study followed the principles of the Declaration of Helsinki and was approved by the Ethics Committee of Hainan Eye Hospital\u0026nbsp;(Approval No. 2024-001-01). The\u0026nbsp;trial registration number was ChiCTR2400083482.\u0026nbsp;All patients were informed and signed an informed consent form.\u003c/p\u003e\n\u003cp\u003eConsent for publication\u003c/p\u003e\n\u003cp\u003eAll authors consent to publication.\u003c/p\u003e\n\u003cp\u003eAvailability of data and material\u003c/p\u003e\n\u003cp\u003eData are available from the corresponding author on reasonable request.\u003c/p\u003e\n\u003cp\u003eCompeting interests\u003c/p\u003e\n\u003cp\u003eXZ, none; SH, none; HD, none; XC, none; LS, none; ZY, none.\u003c/p\u003e\n\u003cp\u003eFunding\u003c/p\u003e\n\u003cp\u003eThis work was supported by grants from Nanhai Junior Talent Program of Hainan Provincial Health Commission (NHXX-WJW-2023020), Hainan Provincial Natural Science Foundation of China (820MS152), Science and Technology Planning Project of Hainan Province (ZDYF2022SHFZ326, LCYX202406), and Hainan Province Clinical Medical Center.\u003c/p\u003e\n\u003cp\u003eAuthors\u0026rsquo; contributions\u003c/p\u003e\n\u003cp\u003eThe study was designed by XZ and SH. Material preparation and data collection were performed by SH, XC, ZY, and LS. Data analysis was performed by SH. The manuscript was written by SH, and reviewed and edited by XZ and HD. All authors read and approved the final manuscript.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eAcknowledgments\u003c/p\u003e\n\u003cp\u003eEditorial support was provided by Lydia Jennings (Illuminate Medical Ltd., UK) and funded by Bausch + Lomb, Inc.\u003c/p\u003e"},{"header":"References","content":"\u003col\u003e\n \u003cli\u003eSekundo W, Kunert KS, Blum M. Small incision corneal refractive surgery using the small incision lenticule extraction (SMILE) procedure for the correction of myopia and myopic astigmatism: results of a 6 month prospective study. Br J Ophthalmol. 2011;95(3):335-9.\u003c/li\u003e\n \u003cli\u003eHu YK, Li WJ, Gao XW, Guo YL. Comparison of small incision lenticule extraction and femtosecond laser assisted LASIK for myopia. Int J Ophthalmol. 2013;13(10):2074-7.\u003c/li\u003e\n \u003cli\u003eGao S, Wu J, Li L, Wang Y, Zhong X. Effects of silicone hydrogel contact lenses on ocular surface after Sub-Bowman\u0026rsquo;s Keratomileusis. Curr Eye Res. 2013;38(11):1118-23.\u0026nbsp;\u003c/li\u003e\n \u003cli\u003eDuru N, Altunel O, Sırakaya E, K\u0026uuml;\u0026ccedil;\u0026uuml;k B. Comparison of the balafilcon A and samfilcon A lenses on postoperative pain control and epithelial healing time after photorefractive keratectomy: a contralateral eye study. Lasers Med Sci. 2020;35(9):1955-60.\u0026nbsp;\u003c/li\u003e\n \u003cli\u003eTaneri S, Oehler S, MacRae S, Dick HB. Influence of a Therapeutic Soft Contact Lens on Epithelial Healing, Visual Recovery, Haze, and Pain After Photorefractive Keratectomy. Eye Contact Lens. 2018;44 Suppl 1:S38-43..\u003c/li\u003e\n \u003cli\u003eWang J, Xi S, Wang B, Chen Z, Zheng K, Zhou X. Clinical Observation of Silicon Hydrogel Contact Lens Fitted Immediately after Small Incision Lenticule Extraction (SMILE). J Ophthalmol. 2020;2020:2604917.\u003c/li\u003e\n \u003cli\u003eGao S, Wu J, Li L, Wang Y, Zhong X (2013) Effects of silicone hydrogel contact lenses on ocular surface after Sub-Bowman\u0026rsquo;s Keratomileusis. Curr Eye Res 38: 1118\u0026ndash;1123.\u003c/li\u003e\n \u003cli\u003eZambelli AM, Brothers KM, Hunt KM, Romanowski EG, Nau AC, Dhaliwal DK, Shanks RM. Diffusion of Antimicrobials Across Silicone Hydrogel Contact Lenses. Eye Contact Lens. 2015;41(5):277-80.\u003c/li\u003e\n \u003cli\u003eCompa\u0026ntilde; V, Andrio A, L\u0026oacute;pez-Alemany A, Riande E, Refojo MF. Oxygen permeability of hydrogel contact lenses with organosilicon moieties. Biomaterials. 2002;23(13):2767-72.\u003c/li\u003e\n \u003cli\u003eXie WJ, Zeng J, Cui Y, Li J, Li ZM, Liao WX, Yang XH. Comparation of effectiveness of silicone hydrogel contact lens and hydrogel contact lens in patients after LASEK. Int J Ophthalmol. 2015;8(6):1131-5.\u003c/li\u003e\n \u003cli\u003eS\u0026aacute;nchez-Gonz\u0026aacute;lez JM, Gargallo-Mart\u0026iacute;nez B, De-Hita-Cantalejo C, Bautista-Llamas MJ. Bandage contact lens use after photorefractive keratectomy: updated review. J Cataract Refract Surg. 2022;48(6):741-2.\u003c/li\u003e\n \u003cli\u003eDuru Z, Duru N, Ulusoy DM. Effects of senofilcon A and lotrafilcon B bandage contact lenses on epithelial healing and pain management after bilateral photorefractive keratectomy. Cont Lens Anterior Eye. 2020;43(2):169-72.\u0026nbsp;\u003c/li\u003e\n \u003cli\u003eMohammadpour M, Amouzegar A, Hashemi H, Jabbarvand M, Kordbacheh\u0026nbsp;H, Rahimi F, Hashemian MN. Comparison of Lotrafilcon B and Balafilcon A silicone hydrogel bandage contact lenses in reducing pain and discomfort after photorefractive keratectomy: A contralateral eye study. Cont Lens Anterior Eye. 2015;38(3):211-14.\u003c/li\u003e\n \u003cli\u003eAkcam HT, Unlu M, Karaca EE, Yazici H, Aydin B, Hondur AM. Autologous serum eye-drops and enhanced epithelial healing time after photorefractive keratectomy. Clin Exp Optom 2018;101(1):34-7.\u003c/li\u003e\n \u003cli\u003eJacobs DS, Carrasquillo KG, Cottrell PD, Fern\u0026aacute;ndez-Vel\u0026aacute;zquez FJ, Gil-Cazorla R, Jalbert I, et al. BCLA CLEAR - Medical use of contact lenses. Cont Lens Anterior Eye 2021;44(2):289-329.\u0026nbsp;\u003c/li\u003e\n \u003cli\u003eBagherian H, Zarei-Ghanavati S, Momeni-Moghaddam H, Wolffsohn JS, Sedaghat MR, Naroo SA, Monfared N. Masked comparison of two silicone hydrogel bandage contact lenses after photorefractive keratectomy. Cont Lens Anterior Eye. 2020;43(3):244-9.\u003c/li\u003e\n \u003cli\u003eSulley A, Dumbleton K. Silicone hydrogel daily disposable benefits: The evidence. Cont Lens Anterior Eye. 2020;43(3):298-307.\u003c/li\u003e\n\u003c/ol\u003e"}],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":true,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":false,"hideJournal":false,"highlight":"","institution":"","isAcceptedByJournal":true,"isAuthorSuppliedPdf":false,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":false,"isPdf":false,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"bmc-research-notes","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":false,"externalIdentity":"resn","sideBox":"Learn more about [BMC Research Notes](http://bmcresnotes.biomedcentral.com)","snPcode":"","submissionUrl":"https://www.editorialmanager.com/resn/default.aspx","title":"BMC Research Notes","twitterHandle":"@BMC_series","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"em","reportingPortfolio":"BMC Series","inReviewEnabled":true,"inReviewRevisionsEnabled":true},"keywords":"Silicone hydrogel, Contact lenses, SMILE, Ocular surface","lastPublishedDoi":"10.21203/rs.3.rs-5407465/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-5407465/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003cp\u003e\u003cstrong\u003ePurpose: \u003c/strong\u003eTo compare the efficacy of two different silicone hydrogel bandage contact lenses on ocular surface after small incision lenticule extraction (SMILE) surgery.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eMethods:\u003c/strong\u003e In this prospective, double-masked, contralateral, comparative clinical study, 25 patients who received SMILE in both eyes wore two different silicone hydrogel bandage contact lenses (BCLs): balafilcon A in one eye and samfilcon A in the other randomly. The scores of BCL deposits on the lens surface and the level of ocular discomfort were assessed on the first day after surgery. Ocular Surface Disease Index (OSDI), the 5-Item\u003cstrong\u003e \u003c/strong\u003eDry Eye Questionnaire (DEQ-5), corneal sensitivity, ocular surface parametersand tear inflammatory mediators were assessed preoperatively and 1 day, 1 week, and 1 month postoperatively.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eResults:\u003c/strong\u003e The scores of BCL deposits were lower in the samfilcon A group than that in the balafilcon A group (samfilcon A vs. balafilcon A: 1.28±0.68 vs. 2.56±0.82, P=0.045). There were no significant differences in subjective symptoms scores, OSDI scores, DEQ-5 scores, corneal sensitivity, ocular surface parameters or tear inflammatory mediators between the BCLs postoperatively (p\u0026gt;0.05).\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eConclusion:\u003c/strong\u003e Both samfilcon A and balafilcon A contact lenses are safe with equivalent efficacy on ocular surface after SMILE. Samfilcon A caused significantly less deposits after SMILE.\u003c/p\u003e","manuscriptTitle":"Clinical Observation of Early Postoperative Wear of Balafilcon A and Innovative First-Generation Samfilcon A Silicone Hydrogel Bandage Contact Lenses after SMILE Surgery","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2024-12-11 13:27:13","doi":"10.21203/rs.3.rs-5407465/v1","editorialEvents":[{"type":"communityComments","content":0},{"type":"decision","content":"Revision requested","date":"2024-11-12T11:52:17+00:00","index":"","fulltext":""},{"type":"editorAssigned","content":"","date":"2024-11-08T09:39:53+00:00","index":"","fulltext":""},{"type":"checksComplete","content":"","date":"2024-11-08T09:38:31+00:00","index":"","fulltext":""},{"type":"submitted","content":"BMC Research Notes","date":"2024-11-07T07:00:49+00:00","index":"","fulltext":""}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"bmc-research-notes","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":false,"externalIdentity":"resn","sideBox":"Learn more about [BMC Research Notes](http://bmcresnotes.biomedcentral.com)","snPcode":"","submissionUrl":"https://www.editorialmanager.com/resn/default.aspx","title":"BMC Research Notes","twitterHandle":"@BMC_series","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"em","reportingPortfolio":"BMC Series","inReviewEnabled":true,"inReviewRevisionsEnabled":true}}],"origin":"","ownerIdentity":"c1321106-db40-4824-b4c4-45d92c07d4d3","owner":[],"postedDate":"December 11th, 2024","published":true,"recentEditorialEvents":[],"rejectedJournal":[],"revision":"","amendment":"","status":"published-in-journal","subjectAreas":[],"tags":[],"updatedAt":"2025-11-03T16:09:13+00:00","versionOfRecord":{"articleIdentity":"rs-5407465","link":"https://doi.org/10.1186/s13104-025-07304-1","journal":{"identity":"bmc-research-notes","isVorOnly":false,"title":"BMC Research Notes"},"publishedOn":"2025-10-27 15:58:16","publishedOnDateReadable":"October 27th, 2025"},"versionCreatedAt":"2024-12-11 13:27:13","video":"","vorDoi":"10.1186/s13104-025-07304-1","vorDoiUrl":"https://doi.org/10.1186/s13104-025-07304-1","workflowStages":[]},"version":"v1","identity":"rs-5407465","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-5407465","identity":"rs-5407465","version":["v1"]},"buildId":"qtupq5eGEP_6zYnWcrvyt","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}