Abstract
Purpose :
Superficial keratectomy with topical disodium ethylenediaminetetraacetic acid (Na2-EDTA) is an established treatment for band keratopathy (BK). Use of the dipotassium form (K2-EDTA) acquired from easily available blood collection vacutainer tubes as an alternative to the commercially available Na2-EDTA was only recently reported in 2018. We report our experience of using K2-EDTA to treat band keratopathy.
Methods :
Retrospective case series of 20 eyes (19 patients) undergoing superficial keratectomy with K2-EDTA chelation from July 2018 to September 2019. Symptomatic BK patients with visual impairment or discomfort from ocular surface instability were included. 12.3% K2-EDTA solution was applied topically after superficial keratectomy and chelation was achieved. Followed by placing a bandage contact lens to facilitate epithelial healing/comfort. Outcomes measured were BCVA, resolution of symptoms, time to re-epithelialisation, recurrence, complications, and need for any further treatment.
Results :
Mean age was 67.4 years (SD 19.2; range: 24 - 88) and 55% were Males. The indications for the procedure included discomfort 12 eyes (60%), impaired vision in 7 (35%) and improve cosmetic appearance in 1 (5%). The mean operation time was 22 minutes (SD 8) timed from application of the drape and including superficial keratectomy. Effective clearance of the BK was accomplished in all patients. No major complications reported. Post op BCVA improved in 4 but remained the same in 3 eyes undergoing the procedure for visual improvement due to associated corneal scarring (n=2) and age-related macular degeneration (n=1). Corneal surface healing was achieved in all patients except one who developed a persistent epithelial defect due to underlying neurotrophic cornea secondary to past acanthamoeba keratitis resolving with temporary lateral tarsorrhaphy. Recurrence of BSK was noted in none of the patients on mean 150 days (SD 121) follow up time.
Conclusions :
Superficial keratectomy with topical 12.3 % K2-EDTA chelation serves as an efficient and safe surgical technique for band shaped keratopathy clearance and is cheaper as compared to the traditional Na2-EDTA solution.
This is a 2021 ARVO Annual Meeting abstract.