| Past Issue | Volume 8, Number 4, August 2006 | | Adjunctive Preoperative Ethylenediaminetetraacetic Acid Drops for Surgical Chelation for Calcific Band Keratopathy |
Safiye Yilmaz, Melih Ture, Ahmet Maden
Department of Ophthalmology, Izmir Atatürk Training and Research Hospital, Izmir, Turkey
Aim: To evaluate the safety and efficacy of adjunctive preoperative topical 10% ethylenediaminetetraacetic acid solution in addition to intraoperative application of the same agent for reducing intraoperative calcium removal times during surgery for calcific band keratopathy.
Methods: In this prospective non-randomised comparative interventional study, 31 eyes of 23 consecutive patients with calcific band keratopathy underwent surgical treatment with intraoperative 10% ethylenediaminetetraacetic acid chelation between January 2002 and December 2004. Eighteen eyes received adjunctive preoperative topical ethylenediaminetetraacetic acid 10% 5 times daily for 3 weeks before surgery (group 1). The remaining 13 eyes did not receive any medication before surgery (group 2). The intraoperative time needed for calcium removal and the corneal re-epithelialisation time were measured in both groups. The patients' symptoms, visual acuities, and ocular findings were recorded preoperatively and postoperatively during the follow-up period.
Results: Discomfort and pain were the presenting complaints for all patients in both groups. The mean surgery time for complete removal of corneal calcium deposition in group 1 was 11.00 minutes (SD, 4.54 minutes), and in group 2 the mean time was 18.71 minutes (SD, 4.54 minutes). The difference was statistically significant (p = 0.023). All eyes (100%) in group 1 re-epithelialised over a mean time of 3.35 days (SD, 1.49 days). Eleven of 13 eyes (85%) in group 2 re-epithelialised over a mean time of 4.57 days (SD, 1.60 days). The remaining 2 corneas from 2 different patients in group 2 failed to re-epithelialise spontaneously and required autologous limbal grafting. There was no statistically significant difference in the re-epithelialisation times between the 2 groups. The average postoperative time for relief of symptoms was 2.58 days (SD, 1.27 days) for patients in group 1 and 6.71 days (SD, 2.09 days) for patients in group 2, which was statistically significant (p = 0.034). Visual acuities improved in 7 of 18 eyes (39%) in group 1, and in 5 of 13 eyes (38%) in group 2. Visual acuities remained at preoperative status for 11 of 18 eyes (61%) in group 1, and 6 of 13 eyes (62%) in group 2.
Conclusions: The use of adjunctive preoperative topical ethylenediaminetetraacetic acid solution in addition to intraoperative ethylenediaminetetraacetic acid application reduced the intraoperative calcium removal times in eyes with calcific band keratopathy and was not associated with any adverse effects. Further studies evaluating the efficacy of topical ethylenediaminetetraacetic acid at different dosages, frequencies, and duration are needed to determine optimal treatment guidelines.
Key words: : Chelation therapy, Corneal opacity, Surgery
Asian J Ophthalmol 2006;8:143-6.
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