The Efficacy of EDTA Chelation on Band Keratopathy

Park, Jung Won; Choi, Sang Kyung

Abstract

We used chemical chelation of EDTA(disodium ethylenediaminetetraacetic acid) to remove calcium hydroxyapatite in the Bowmans layer of band keratopathy and assessed the efficacy in reduction of corneal opacity, relief of ocular discomfort, improvement of visual outcome and prevention of recurrence. A series of 12 eyes with band keratopathy was treated by chemical chelation of EDTA, with a mean follow up period of 8.5 months (range 6 to 15 months). After topical anesthetic instillation, the epithelium should first be removed. The EDTA is then applied repeatedly in a saturated cellulose sponge of 0.05mol solution for 10 minutes. Thereafter the corneal surface is scraped with spatula until the gritty sensation disappears. After calcium removal, the eye was patched for a while to allow the epithelium to heal with the daily use of topical antibiotics. The complete recovery of corneal clarity was observed in 4 eyes and slight corneal opacity remained in 12 eyes. Mild foreign body sensation persisted in 1 eye. Increased visual outcome by 2 lines was observed in 3 eyes. The corneal epithelium healing was completed within 3 days in 10 eyes. Recurrent corneal erosions was observed in 2 eyes but disappeared within 3 weeks by appropriate treatment. No recurrence was observed. We recommend a chemical chelation of EDTA to treat band keratopathy as a primary method in virtue of its simplicity, effectiveness and safety.