Effectiveness of calcific band keratopathy treatment with Ethylenediaminetetraacetic acid combined with cataract extraction in pediatric patients
DOI:
https://doi.org/10.31288/oftalmolzh202442327Keywords:
Calcific band keratopathy, cataract, Ethylenediaminetetraacetic acidAbstract
Purpose. To demonstrate the effectiveness of combined surgery including calcific band keratopathy (CBK) treatment followed by cataract extraction with intraocular lens (IOL) implantation in pediatric patients, assessed through preoperative and postoperative best-corrected visual acuity (BCVA) and changes in corneal transparency.
Methods. This retrospective study was conducted on the medical records of patients treated for CBK combined with cataract secondary to chronic uveitis between January 2018 and December 2020. The study included 15 eyes of 14 pediatric patients. Clinical parameters recorded included age, primary diagnosis, and preoperative and postoperative BCVA using a Tumbling E chart. Postoperative data were collected at 3 days, 6 months, and 12 months after surgery.
Results. Preoperative BCVA averaged 2.03 ± 0.69. On the 3rd postoperative day, BCVA improved to 0.82 ± 0.39, with further improvements to 0.78 ± 0.43 at 6 months and 0.69 ± 0.45 at 12 months. The mean BCVA increased by 2 lines, and BCVA improved by 6 lines within one year postoperatively. Recurrence of CBK was observed in 3 eyes (20%) at 6-month follow-up.
Conclusion. Simultaneous EDTA chelation of calcium plaques and phacoaspiration with IOL implantation is an effective and safe treatment for CBK combined with cataract in pediatric patients. This combined approach resulted in significant improvements in visual acuity and corneal transparency and symptomatic relief. However, the high recurrence rate indicates the need for further research.
References
Barouch FC, Colby K. Corneal and conjunctival degenerations. In: Foster CS AD, Dohlman CH, editor. Smolin and Thoft's: The Cornea Scientific Foundations & Clinical Practice 4th ed. Philadelphia: Lippincott, Williams & Wilkins; 2005. p. 875-7.
Mansour AM, Haddad R. Optical coherence tomography of band keratopathy. BMJ Case Rep. 2016;2016. https://doi.org/10.1136/bcr-2016-218216
Chan NS-W, Choi J, Cheung CMG. Pediatric Uveitis. Asia-Pacific Journal of Ophthalmology. 2018;7(3):192-9.
Al-Hity A, Ramaesh K, Lockington D. EDTA chelation for symptomatic band keratopathy: results and recurrence. Eye (Lond). 2018;32(1):26-31. https://doi.org/10.1038/eye.2017.264
Narvaez J, Chang M, Ing J, De Chance D, Narvaez JJ. Simplified, Readily Available Method for the Treatment of Band Keratopathy With Ethylenediaminetetraacetic Acid. Cornea. 2021;40(10):1360-2. https://doi.org/10.1097/ICO.0000000000002635
Guo Z, Henry RK, Dastjerdi MH. Comparative Analysis of Alternative Calcium Chelators for the Treatment of Calcific Band Keratopathy. Cornea. 2023;42(12):1551-4. https://doi.org/10.1097/ICO.0000000000003370
Bakri MH, Ismail EA, Ali MS, Elsedfy GO, et al. Behavioral and emotional effects of repeated general anesthesia in young children. Saudi J Anaesth. 2015;9(2):161-6. https://doi.org/10.4103/1658-354X.152843
Choi J, Hawley DP, Ashworth J, Edelsten C, Bossuyt A. An update on the modern management of paediatric uveitis. Br J Ophthalmol. 2019;103(12):1685-9. https://doi.org/10.1136/bjophthalmol-2019-314212
Abdi P, Asadigandomani H, Amirkhani A, Taghizadeh S, Nozarian Z. Familial primary calcific band-shaped keratopathy with late onset systemic disease: a case series and review of the literature. J Med Case Rep. 2024;18(1):98. https://doi.org/10.1186/s13256-024-04429-y
Sen ES, Ramanan AV. Juvenile idiopathic arthritis-associated uveitis. Best Pract Res Clin Rheumatol. 2017;31(4):517-34. https://doi.org/10.1016/j.berh.2018.01.002
Kaur K, Gurnani B. Viscoelastics. StatPearls. Treasure Island (FL): StatPearls Publishing, 2024, StatPearls Publishing LLC; 2024.
He K, Liao M, Zhu Y, Cui B, et al. Risk Factors for Band Keratopathy in Aphakic Eyes With Silicone Oil Tamponade for Open-Globe Injuries: A Multicenter Case-Control Study. Front Med (Lausanne). 2021;8:713599. https://doi.org/10.3389/fmed.2021.713599
Doostdar N, Manrique CJ, Hamill MB, Barron AR. Synthesis of calcium-silica composites: a route toward an in vitro model system for calcific band keratopathy precipitates. J Biomed Mater Res A. 2011;99(2):173-83. https://doi.org/10.1002/jbm.a.33172
Gaballa SA, Kompella UB, Elgarhy O, Alqahtani AM, et al. Corticosteroids in ophthalmology: drug delivery innovations, pharmacology, clinical applications, and future perspectives. Drug Deliv Transl Res. 2021;11(3):866-93. https://doi.org/10.1007/s13346-020-00843-z
Thorne JE, Woreta FA, Dunn JP, Jabs DA. Risk of cataract development among children with juvenile idiopathic arthritis-related uveitis treated with topical corticosteroids. Ophthalmology. 2010;117(7):1436-41. https://doi.org/10.1016/j.ophtha.2009.12.003
Bee CR, Koenig LR, Hwang ES, Koenig SB. Removal of calcific band keratopathy without ethylenediaminetetraacetic acid (EDTA) in eyes with limited visual potential. Clin Ophthalmol. 2018;12:1895-9. https://doi.org/10.2147/OPTH.S177636
Jhanji V, Rapuano CJ, Vajpayee RB. Corneal calcific band keratopathy. Curr Opin Ophthalmol. 2011;22(4):283-9. https://doi.org/10.1097/ICU.0b013e3283477d36
Kobayashi W, Yokokura S, Hariya T, Nakazawa T. Two percent ethylenediaminetetraacetic acid chelation treatment for band-shaped keratopathy, without blunt scratching after removal of the corneal epithelium. Clin Ophthalmol. 2015;9:217-23. https://doi.org/10.2147/OPTH.S75938
Epstein SP, Ahdoot M, Marcus E, Asbell PA. Comparative toxicity of preservatives on immortalized corneal and conjunctival epithelial cells. J Ocul Pharmacol Ther. 2009;25(2):113-9. https://doi.org/10.1089/jop.2008.0098
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