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Dr. Chynn on besivance


Anyone had issues with poor epithelial healing (or even corneal melts) with Besivance?
I’ve heard of this but think it’s BS because I’ve done literally 1,900 LASEKs using Besivance so if there was a true association I’d notice it by now as melts would be more common in ASA than in LASIK
The only thing that makes sense is you shouldn’t apply it under the BCL after LASIK BC it’s so lubricating BC of vehicle that it causes flap slippage. Even that’s not a problem if you apply it on top of the BCL
I have taken care of two patients s/p PRK who had severely delayed epithelial healing with consequent haze and loss of BSCVA.  Both patients were on Besivance and healed within four days once the Besivance was stopped.  Both required retreatment.  I do not use Besivance in the presence of an epi defect regardless of etiology.  I believe ASCRS issued a warning about Besivance and other meds that were implicated in a delay of healing.
With all due respect I think the warning is BS
I’m performing about 1000 ASAs per year. So my yearly experience exceeds the entire lifetime experience of the MDs who issued that warning
If Besivance caused delayed reepithelialization I’d have noticed that when I switched from another fluroquinolone in the 1-eyed trial I conducted with my fellows before we deemed it safe enough to switch
Please forgive me for not taking 100 hrs to publish that as I don’t have a base income provided by an academic position or consulting retainers"</p

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