title: Delayed Epithelial Closure After PRK Associated With Topical Besifloxacin Use.
abstract: OBJECTIVE
  To report the observation of prolonged reepithelialization after photorefractive keratectomy (PRK) associated with the use of besifloxacin 0.6% (Besivance; Bausch & Lomb, Rochester, NY) underneath bandage contact lenses (BCLs) placed during surgery.
  
  
  METHODS
  An office-based private practice and retrospective chart review. The healing parameters examined included epithelial healing time, haze formation, discomfort, and visual recovery of 4 patients (7 eyes) treated with besifloxacin 0.6% under BCLs placed after the PRK was performed.
  
  
  RESULTS
  All the eyes had delayed epithelial closure (mean, 8.8 days; range 5-13 days). All the patients experienced a delayed visual recovery and significant pain after the surgery, and 2 of 4 patients experienced recurrent corneal erosions for weeks to months after they underwent the PRK. All but 1 eye developed corneal haze persisting for 1 year or more after the surgery. Only 1 eye among the 7 eyes treated with besifloxacin 0.6% under the BCL had 20/20 or better uncorrected visual acuity 3 months postoperatively.
  
  
  CONCLUSIONS
  All the patients treated with besifloxacin 0.6% on the stromal bed exhibited significant problems with corneal epithelial healing and delayed visual recovery. We caution the use of besifloxacin 0.6% underneath a BCL during a PRK or other ocular surface surgeries requiring corneal epithelial debridement.
authors: Talamo Hatch Laser Eye Consultants, Waltham, MA.
authors: Jonathan H
authors: JH
authors: Talamo
authors: Kathryn M
authors: KM
authors: Hatch
authors: Emily C
authors: EC
authors: Woodcock
mesh_terms: D000287:Administration, Topical; D000900:Anti-Bacterial Agents / Q000009:adverse effects; D001381:Azepines / Q000009:adverse effects*; D003316:Corneal Diseases / Q000139:chemically induced* / Q000503:physiopathology; D058447:Eye Pain / Q000139:chemically induced / Q000175:diagnosis / Q000503:physiopathology; D024841:Fluoroquinolones / Q000009:adverse effects*; D006801:Humans; D054018:Lasers, Excimer / Q000627:therapeutic use*; D009216:Myopia / Q000601:surgery; D020795:Photophobia / Q000139:chemically induced / Q000175:diagnosis / Q000503:physiopathology; D018903:Photorefractive Keratectomy; D062326:Re-Epithelialization / Q000187:drug effects*; D012189:Retrospective Studies; D059005:Topoisomerase II Inhibitors / Q000009:adverse effects*; D014786:Vision Disorders / Q000139:chemically induced / Q000175:diagnosis / Q000503:physiopathology; D014792:Visual Acuity / Q000187:drug effects / Q000502:physiology; D014945:Wound Healing / Q000187:drug effects* / Q000502:physiology
chemical_list: D000900:Anti-Bacterial Agents; D001381:Azepines; D024841:Fluoroquinolones; D059005:Topoisomerase II Inhibitors; C522124:besifloxacin