Two percent ethylenediaminetetraacetic acid chelation treatment for band-shaped keratopathy, without blunt scratching after removal of the corneal epithelium

Figures & data

Table 1 Patient characteristics and causes of BSK

Characteristics	Number, mean ± SD	Cause	Eyes, n %
Age (years)	71.7±15.0	Idiopathic	13	54.2
Sex		Chronic renal failure	5*	20.8
Male	7 (9 eyes)	Diabetes mellitus	8*	33.3
Female	9 (15 eyes)	Hypercalcemia	0	0
Laterality		Hyperparathyroidism	0	0
Right	11	Sarcoidosis	0	0
Left	13

Note:

* Two eyes had both chronic renal failure and diabetes mellitus.

Abbreviations: BSK, band-shaped keratopathy; SD, standard deviation.

Figure 1 Surgical technique.

Notes: (A) Removal of the corneal epithelium from the area of the opacity with a golf club spud. (B) Applying a fragment of MQA (surgical sponge) dipped in EDTA to the opacity. (C) Checking for any remaining opacity with a light guide.
Abbreviation: EDTA, ethylenediaminetetraacetic acid.

Table 2 Pre- and post-operative characteristics

Characteristics	Pre-operative	Post-operative	P-value
Mean BCVA (logMAR)	0.69±0.76	0.41±0.67	<0.01*
Corneal curvature radius
K1	7.81±0.34	7.80±0.34	0.54
K2	7.54±0.33	7.67±0.31	0.49
Km	7.68±0.31	7.66±0.33	0.45
IOP (mmHg)	15.2±4.4	14.1±4.0	0.24
Corneal endothelial cells (per mm^2; 10 eyes)	2,342.2±985.6	2,250.2±749.0	0.95
CV (8 eyes)	29.1±6.7	27.8±7.3	0.58
Hexagonal cells (%HEX; per mm^2; 8 eyes)	47.5±14.7	61.4±8.0	<0.05*

Notes: K1, horizontal meridian; K2, vertical meridian; Km, average of K1 and K2. Mann-Whitney U-test; GraphPad Prism version 6 (GraphPad Software, San Diego, CA, USA).

* Indicates a significant difference.

Abbreviations: CV, coefficient of variation; IOP, intraocular pressure; BCVA, best-corrected visual acuity; logMAR, logarithm of the minimum angle of resolution.

Figure 2 Representative images of eyes with BSK before (A) and after (B) EDTA chelation. The patient’s symptoms resolved completely after the procedure.

Abbreviations: BSK, band-shaped keratopathy; EDTA, ethylenediaminetetraacetic acid.

Table 3 Visual outcomes after EDTA treatment

Visual acuity at 1-month follow-up (number of eyes)
Initial visual acuity	<20/400	20/400 to 20/200	20/100 to 20/50	≥20/40	Total	%
<20/400	1	0	0	0	1	4.2
20/400 to 20/200	1	1	0	0	2	8.3
20/100 to 20/50	1	1	2	0	4	16.7
≥20/40	1	0	8	8	17	70.8
					24	100
Number of lines of visual improvement (+) or worsening (−) compared with a previous report
	−2	−1, 0, +1	+2, 3	+4
2% EDTA treatment	0%	50%	29.2%	20.8%

Abbreviation: EDTA, ethylenediaminetetraacetic acid.