RCE Treatment Query

Two years ago I had RCE in my left eye. After months of unexpected symptoms and no success with lens treatment, my doctor scraped the cornea and it finally healed. At the time, I'd had some tetracycline leftover from previous acne treatment and I'd read that it may aid in the healing process. I asked my  opth doctor about taking it and he said i could that it couldn't hurt, so I did at bedtime for a month or two. I had no more RCE symptoms.
Now, my right eye has had RCE for about 2-3 months with symptoms worsening/increasing in the past month. I went to a differnet doctor and had ASP but it was unsuccessful and my cornea tore 2 days later. I found my previous doctor (he'd opened his own practice) and a had my cornea scraped/layers removed 5 days ago. (It was so painful for 2-3 days afterwards!) The area is right over my pupil and 5 mm in size. Three days later it tore after only 3 hours of sleep.
I'm going for follow up in two days and I'm wondering if I should have him start me on tetracycline again?
Also I've read about using TCN and a steroid eye drop in conjunction. However, one of my steroid eye drops says that it can be damaging to the cornea.
What would your recommendation be?

[Michael J Kutryb, MD]

First, you have to go easy on the abbreviations.  Go ahead and use the full words so we all know what you are talking.  I believe by ASP you mean anterior stromal puncture and RCE means recurrent corneal erosion.  In my opinion if you don't have eyelid margin disease of any sort, the tetracycline would be of limited benefit.  I don't see much downside, however, if used in 50mg a day dose and directed by your doctor so all contraindications are looked into by him.  The key in my experience is to leave the bandage contact lens in as long as possible - sometimes for several weeks until the epithelium toughens up again.  A good mutivitamin supplement should be helpful as well.  I try to avoid steroid drops until the epithelium is well intact and then only sparingly for select patients.