OBJECTIVE To compare the efficacy and safety of conventional lenses and silicone hydrogel lenses in the treatment of bullous keratopathy. The silicone hydrogel bandage contact lenses used were Focus NIGHT & DAY and PureVision. The conventional lens used was Sauflon 85%. METHODS This was a prospective, comparative study of 22 patients with painful bullous keratopathy in one eye. Patients visited a specialty contact lens department and were fitted with all three different lens types in their affected eye for 1 month each, for a total duration of 3 months. The main outcome measures were comfort and pain relief, which patients scored on a scale that ranged from 1 to 5, with 1 being very poor and 5 being excellent. Doctors assessed the fit of the lens, its movement, and any deposit buildup. The statistical tests applied were the Kruskal-Wallis test and the Mann-Whitney test. RESULTS Sixteen of the 22 patients (24 eyes) successfully completed 1 month's wear of all three bandage contact lenses. The median comfort score was 3.9 for PureVision, 3.8 for Focus NIGHT & DAY, and 2.8 for Sauflon 85%; there was a statistical significance among the three groups (P=0.031). Silicone hydrogel lenses performed better than conventional lenses for comfort. The Mann-Whitney test showed that there was no statistically significant difference for comfort scores of Focus NIGHT & DAY versus PureVision (P<0.782) or of Focus NIGHT & DAY versus Sauflon 85% (P<0.073). However, there was a statistically significant difference for comfort scores of PureVision versus Sauflon 85% (P<0.0136). The median pain relief score was 3.8 for PureVision, 3.7 for Focus NIGHT & DAY, and 3.2 for Sauflon 85%. There was no significant difference among the three lenses for pain relief score. All three lens types were similarly good with regard to contact lens fit, movement, and deposit buildup. CONCLUSIONS The use of silicone hydrogel lenses are a safe and effective alternative to conventional contact lenses for the treatment of bullous keratopathy.