MANAGEMENT OF CORNEAL CALCIFICATION AFTER CORNEAL FOREIGN BODY REMOVAL
Published 2022 - 26th ESCRS Winter Meeting
Reference: P119 | Type: Abstracts | DOI: 10.82333/v680-m507
Authors: Ismael Bakkali El Bakkali* 1 , Pablo Cisneros Arias 1 , Ana Boned Murillo 1 , María Dolores Díaz Barreda 1 , Francisco Javier Ascaso Puyuelo 1 , María Ángeles Del Buey Sayas 1
1Ophthalmology,Hospital Clinico Universitario Lozano Blesa,Zaragoza,Spain
Purpose
To describe a case of corneal calcification after a metallic corneal foreign body, as well as the medical and surgical management.
Setting
Calcific band keratopathy (CBK) is a widely known cause of corneal calcification, in which calcium accumulates in the superficial layers of the cornea due to chronic ocular inflammation or systemic hypercalcemia. The most common methods of removing the calcium include chemical chelation with ethyl-enediaminetetraacetic acid (EDTA) and mechanical debridement.
In the case we present, calcium deposits occurred after removing a corneal foreign body.
Methods
A 45-year-old male presented with pain and redness in the left eye after being working with a radial saw the day before. Slit lamp examination showed a metallic foreign body in the central cornea. Visual acuity (VA) of the left eye was 0.9 (decimal). The foreign body was removed with a 25 Gauge needle, and the patient was treated with terramycin ointment and artificial tears.
Ten days later he came again referring visual acuity loss, presenting a VA in the left eye of light perception and a 5x6mm central corneal calcification. He was treated with topical EDTA and cycloplegic drops. Five days later, he had a mechanical debridement in the left cornea assisted with EDTA drops during the surgery.
Results
After ten days of postoperative treatment with EDTA drops, he reached a VA in the left eye of 0.25. We removed EDTA and prescribed fluorometholone drops. Blood levels of calcium and phosphorus were normal.
Two months later, the patient reached a VA of 0.9, and presented a transparent cornea without any calcium deposits.
Conclusion
Corneal calcification may be a potential complication of metallic corneal foreign bodies. It is important to check out for possible calcium and phosphorus blood level abnormalities. EDTA drops may be useful for the treatment of corneal calcifications before, during and after the debridement. Using phosphate-rich drops and ocular ointments may be associated with a higher risk of corneal calcium deposits, but further studies with a larger sample are needed to confirm these findings.