Tri-potassium EDTA chelation for calcific band keratopathy: results and long-term follow-up

Session Details

Session Title: Cornea & Miscellaneous
Session Date/Time: Saturday 22/02/2020 | 08:30-11:10
Paper Time: 10:14
Venue: Auditorium des Ministres.

First Author: D.Dibina RUSSIA
Co Author(s): B. Malyugin  N. Anisimova  -. -           

Abstract Details

Purpose:

To report the case series of corneal deposits, to assess the long-term follow-up after Tri-potassium Ethylenediaminetetraacetic Acid (K3-EDTA) chelating solution in patients with band keratopathy (BK) and to perform laboratory analysis of the diseased cornea.

Setting:

S. Fyodorov Eye Microsurgery Federal State Institution, Moscow, Russia

Methods:

Six eyes of five patients with BK associated with chronic intraocular inflammation,long-term intraocular silicone oil or intensive topical glaucoma therapy are described.At the primary examination cornea was revealed with calcium deposits in the central area of the cornea.BCVA was 0.06+0.12,ССT was 728+98.4µm. Serum analysis identified in four cases normal levels of calcium, phosphorus, vitamin D and thyroid hormones,but one patient had a high level of triiodothyronine total(T3)–5,8 mmol/L, vitamin 25(OH)D–11ng/ml and parathyroid hormone 7,5ng/ml. Scanning electron microscopy analysis of the evaporated tear fluid samples of all patients and control groups without BK was performed.

Results:

Treatment included epithelium removal, application of topical K3-EDTA solution and additional debridement. The sample from the corneal scarification was investigated by scanning electron microscopy, spectrometry and light microscopy. Postoperatively BCVAwas0.09+0.12, CCT was 592+58.2µm. All eyes had reepithelialized by the 1-week follow-up period. Histological examination identified calcification deposits.SEM revealed a bumpy surface with a multilayered symmetrical pattern. Elemental analysis of a corneal scraping was mainly composed of calcium, phosphorus and oxygen.In the tears of the control groups and the patients with BK calcium and phosphorus no elevated contents were detected. The follow-up time after K3-EDTA chelation was from 1to12months.

Conclusions:

The use of K3-EDTA solution in the treatment of BK have begun in 1952,although standardized guidelines don’t exist for EDTA chelation in BK,the process varies widely.In our method, we used K3-EDTA solution to remove calcium deposits.Chelation of corneal calcium deposits with topical K3-EDTA is a safe and effective treatment for the BK.The procedure effectively cleared the plaques and provided effective symptomatic relief.

Financial Disclosure: