Comment from another MD
Evan’s post was asking “anyone had issues with poor epithelial healing (or even corneal melting) with Besivance”. My response is based on my clinical referral practice and the attached document.
Please note this section from the attached document:
These medications contain vehicles that have the potential to be sequestered beneath a LASIK flap or a bandage contact lens following PRK and not absorbed. The ASCRS Cornea and Refractive Surgery Clinical Committees have become aware of several cases of flap slippage and/or diffuse lamellar keratitis (DLK) following LASIK when topical ophthalmic medications with these advanced vehicles have been instilled immediately prior to LASIK or intraoperatively while the flap has been elevated. There have been no problems documented with the use of these medications after the flap has been properly positioned. There have also been documented cases of poor epithelial healing when topical ophthalmic medications with these advanced vehicles have been instilled on the stromal bed following PRK prior to placement of a bandage contact lens.
I have bolded the section that was relevant to my post. Emil, I think there may a significant difference in wound healing between LASEK and the epi defect in PRK. In any event, I do not use Besivance in the presence of an epithelial defect.
Dr. Chynn’s answer