The authors describe a retrospective analysis of 89 eyes from 72 patients who underwent ethlenediamine tetra-acetic acid (EDTA) chelation for band keratopathy. The ratio of R:L eye was 41:48. The mean age was 71 years (range 18-93 years). Thirty-two out of 89 cases of band keratopathy were idiopathic (36%). The most common underlying diagnosis was long-term topical glaucoma therapy (27%). The median presenting visual acuity was 6/18 (range 6/6-NPL) with the visual axis affected in 97.8% of cases. The mean duration of the operation was 20 minutes (range 10-45mins); which involved corneal epithelium removal, recurrent application of topical EDTA, and mechanical debridement. The mean initial follow-up time was 40 days. At follow-up, the visual axis was found to be clear in 97.8% of cases. Visual acuity was maintained or improved in 79.8%, with 13.5% improving by two lines or more. One case had a residual epithelial defect at four weeks follow-up, which subsequently healed. The mean length of total follow-up was 581 days. Twenty-five eyes (28.1%) showed localised recurrence of calcium with a mean time of 546 days but only four cases (4.5% overall) required repeat EDTA chelation. Nearly half of these cases of recurrence (11/25) had an initial visual acuity of less than 6/120, and the most common diagnoses in this recurrence group were hypotony or chronic silicone oil retention. The study highlights that EDTA chelation is safe and effective and improves vision in most cases. It is associated with a low recurrence rate.

EDTA chelation for symptomatic band keratopathy: results and recurrence.
Al-Hity A, Ramaesh K, Lockington D.
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Sofia Rokerya

MBBS MRCOphth FRCSI, King's College University Hospital, UK.

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