A case of Primary Band Keratopathy Treated by EDTA Application in Patient with Hyperparathyroidism

PURPOSE: We report a case of band keratopathy caused by hyperparathyroidism which was treated using EDTA (disodium ethylenediaminetetraacetic acid). METHODS: A 33-year-old woman with band keratopathy caused by hyperparathyroidism with elevated serum calcium, without any eye abnormalities was seen at Korea university hospital. Her corneal epithelium was removed after topical anesthesia, and the lesion was exposed by chemical chelating agent of 0.02M EDTA for 10 minutes, then, dropped topically every 30 seconds, the grayish white opacity which presents the calcium deposits was removed by chemical chelation of 0.02M EDTA in cornea. RESULTS: Most of the opacity was disappeared by chemical chelation with improvement of vision by 4 lines from 10/100 to 10/20. Cosmeticity was improved dramatically as well. No recurrence of corneal opacity was observed at 14 months after the operation. CONCLUSIONS: We experienced one case of band keratopathy caused by only hyperparathyroidism with hypercalcemia, without chronic uveitis, glaucoma, corneal edema, recurrent trauma any eye abnormalities. The primary band keratopathy was successfully treated by chemical chelation of EDTA : visual acuity was improved, foreign body sensation was relieved, and good cosmetic results were achieved. To our best knowledge, this is the first case of primary band keratopathy with hyperparathyroidism with hypercalcemia without any eye abnormalities, and we successfully treated by chemical chelation of EDTA.

Risk Factors of Intraocular Pressure Elevation after Pars Plana Vitrectomy

The medical records of 206 eyes of 206 consecutive patients who underwent pars plana vitrectomy between March 1994 and October 1998, were reviewed retrospectively to determine the incidence and risk factors of postoperative intraocular pressure elevation. The mean follow-up period was 104.2 weeks. Early(within 7 days of surgery)and late postoperative intraocular pressure elevation(>21mmHg)occurred in 83 eyes(40.3%)and 84 eyes(40.7%), respectively. Injection of the gas increased the incidence of early postoperative intraocular pressure elevation significantly(Chi-square univariate analysis;P=0.046, Multivariate logistic regression analysis;odds ratio=1.928, confidence interval 1.079~3.480). Patients undergoing pars plana vitrectomy with gas tamponade must be carefully followed after surgery due to high incidence of postoperative intraocular pressure elevation.

A Case of Lacquer Crack Formation at the Site of Subretinal Bleeding in High Myopic Eye

Lacquer cracks represent the healed mechanical breaks of retinal pigment epithelium, Bruch's membrane, and choriocapillaris complex.The etiologic mechanism of new lacquer cracks in high myopia has not yet been elucidated. Recently, cases in which new lacquer cracks formed at the site of the previous subretinal bleeding have been reported and it has been postulated that the subretinal bleeding may be the precursor of lacquer cracks formation in high myopia.Herein, we present our patient who developed a new lacquer crack at the site of previous subretinal bleeding with a brief literatures review.