Band keratopathy due to hyperparathyroidism

Area of Science:

• Ophthalmology
• Endocrinology
• Nephrology

Background:

• Hyperparathyroidism can lead to systemic complications, including ocular manifestations.
• Corneal calcifications are a rare but significant complication that can impair vision.
• Phosphate treatment has been associated with the development of corneal calcifications in some cases.

Purpose of the Study:

• To report a case of corneal calcifications secondary to hyperparathyroidism and phosphate treatment.
• To evaluate the efficacy of ethylenediaminetetraacetic acid (EDTA) in treating persistent corneal calcifications.
• To investigate the role of mechanical epithelial removal in enhancing EDTA treatment.

Main Methods:

• A patient with hyperparathyroidism and persistent corneal calcifications was treated.
• Local instillation of ethylenediaminetetraacetic acid (EDTA) was administered.
• Mechanical removal of the corneal epithelium was performed prior to EDTA application in a subsequent treatment phase.

Main Results:

• Corneal calcifications persisted for 3.5 years despite initial EDTA treatment.
• Complete elimination of corneal deposits was achieved after mechanical epithelial removal followed by local EDTA application.
• The treatment was effective in resolving the ocular manifestation without apparent adverse effects.

Conclusions:

• Corneal calcifications in hyperparathyroidism can be refractory to standard treatments.
• Combined mechanical epithelial debridement and topical EDTA is a highly effective treatment for corneal calcifications.
• This approach offers a potential solution for vision-impairing ocular complications in endocrine disorders.