APPLICATION OF A NEW PROTOCOL FOR BAND KERATOPATHY TREATMENT WITH ETHYLENEDIAMINETETRAACETIC ACID (EDTA): A CASE SERIES

To evaluate the effectiveness and safety profile of a simple and easy to obtain in daily clinical practice ethylenediaminetetracetic acid (EDTA) solution for the treatment of calcific band keratopathy.

Department of Ophthalmology, Centro Hospitalar Vila Nova de Gaia/Espinho, Vila Nova de Gaia, Portugal.

A prospective case series was conducted including patients with calcific band keratopathy diagnosis. A simple protocol for EDTA solution preparation was followed, according to previous literature: a purple-topped 10-mL K2EDTA Vacutainer blood collection tube containing 18 mg of K2EDTA was used; after tube cap removal, 0.3 mL of sterile water was injected into the tube containing; then a sterile cotton–tipped applicator was used to absorb the fluid, followed by sweeping of the interior surface of the tube to dissolve the K2EDTA coating the inside, creating an EDTA solution.

A total of 3 patients were enrolled. Patient 1 was a 79-year-old man and patient 2 an 82-year-old woman, both with idiopathic band keratopathy. Patient 3 was a 21-year-old man with band keratopathy secondary to chronic ocular inflammation. All patients presented with symptomatic band keratopathy affecting the visual axis. Treatment procedure involved corneal epithelium removal with alcohol 15% solution, recurrent application of topical EDTA solution obtained as previously described, and subsequent debridement.  An amniotic membrane transplant was performed in patients considered to be at risk for persistent epithelial defect. Close follow‐up of the patients was assured after the procedure and anterior segment photos were taken in each visit, demonstrating a good anatomical response and visual acuity maintenance or improvement after treatment.

Calcific band keratopathy is a degenerative corneal disease that primarily affects the Bowman layer, characterized by fine calcium opacities which form a horizontal band towards the central cornea. EDTA is the most widely used treatment, acting as a calcium chelating agent, and was originally derived from Na2EDTA. Given the necessity of specially equipped pharmacies to obtain this agent, simple and easy protocols are needed for routine clinical practice. In this case series, we used a recently published protocol for K2EDTA obtention which proved to be easily available and effective for the treatment of band keratopathy.