EDTA Chelation for Calcific Band Keratopathy

Abstract

Abstract: : Purpose: To evaluate the efficacy of EDTA chelation for clinically significant calcific band keratopathy (CSCBK). Methods: All charts of 224 patients with the diagnosis of CSCBK who presented to our clinic between January 1998 and January 2001 were reviewed retrospectively. CSCBK was defined as central band involving the visual axis or symptomatic band causing foreign body sensation, tearing or recurrent erosions. 55 eyes of 46 patients (20.5%) underwent EDTA chelation. All other patients (79.5%) were treated medically with partial or complete symptomatic relief. The mean follow-up period after EDTA chelation was 3.2 years (0-28 years). Visual outcome and ocular comfort were assessed before and after the EDTA procedure. A Fisher exact t-test was used to compare the results. Results: There was a statistically significant increase in the number of eyes with VA=20/100 or better in the post-treatment vs. pre-treatment groups. [20 (40.8%) vs. 29 (59.2%); p=0.03]. However, there was no statistically significant change in the number of eyes with VA=CF or worse in the post-treatment vs. pre-treatment groups. [14 (28.6%) vs. 13(26.5%); p=0.17]. 15 eyes (27.3%) had visual improvement of 2 or more lines on the Snellen chart after treatment. All patients reported improvement in their symptoms after EDTA chelation. Recurrence of band keratopathy was seen in 7 (12.7%) eyes at a mean time of 9.8 years (5 months-26 years). Conclusions: EDTA chelation remains an effective, simple and inexpensive method to improve visual acuity and symptoms in patients with calcific band keratopathy and should be considered as the initial surgical procedure, as well as for recurrences, after conservative treatment fails.

Keywords: calcium • degenerations/dystrophies • cornea: clinical science