Uveitic band keratopathy: child and adult

Abstract

BackgroundCalcified band keratopathy is a chronic degenerative disease characterized by the deposition of gray to white opacity in superficial layers of the cornea that typically develops over months or years. It is associated with a variety of conditions, including chronic uveitis.PurposeThe objective of this study is to assess visual acuity and corneal changes in patients with band keratopathy secondary to uveitis who underwent phototherapeutic keratectomy (PTK).SettingThe place where this study was performed was in the Department of Ophthalmology and Visual Sciences, Federal University of Sao Paulo.DesignThis is a retrospective study.MethodsPatients with uveitic band keratopathy were submitted to PTK. The PTK was performed using Allegreto Wave EX500, with the ablation area of 6 mm.ResultsTwelve patients (13 eyes) diagnosed with band keratopathy secondary to chronic uveitis were analyzed. Of the 12 patients, 8 patients were female (66 %), aged 22 years (7–53 years). From the 12 patients (13 eyes) evaluated in this study, only one patient (one eye) did not have visual improvement, due to epithelial deposits 2 weeks after PTK, and all the others benefited with the procedure. In the children group, all eyes had visual improvement, and quantitatively speaking, the children had a more significant improvement than adults.ConclusionsPTK is a safe and effective procedure even for children. However, the improvement in visual acuity was restricted due to other ocular changes secondary to uveitis, such as cataract and retinal changes, or even the corneal irregularity.

Effect of Uveitis on the Development of Keratopathy: A Population-Based Cohort Study

“…In the current study, the IRR of keratopathies in patients diagnosed with uveitis is higher than that in the control group with a significantly greater aHR and cumulative probability. Except for the development of band keratopathies in uveitic patients reported previously, 20 the current study showed a universal risk of developing keratopathies in the whole uveitis population by excluding the occurrence of band keratopathies. Moreover, the previous studies mainly focused on the correlation between the anterior uveitis and corneal disorders, [14][15][16] whereas panuveitis yielded a significant effect on the development of keratopathies in the current study.…”

“…The previous studies showed that uveitis, especially chronic uveitis, would lead to band keratopathy. 20,21 Nevertheless, the inflammatory process in uveitis that involves cytokine alteration such as IL-6 and TNF may influence the corneal condition, 17 because the use of cyclosporine that suppresses interleukin activity can relieve some categories of keratopathies. 22 Moreover, the corneal endothelial cells were damaged with an altered central corneal thickness in patients with uveitis, [14][15][16]23 whereas inflammatory cell infiltration into the corneal stoma was also observed during the onset of anterior uveitis.…”

“…Moreover, band keratopathy (ICD-9 codes: 371.43) was also excluded because uveitis is a known risk factor for band keratopathy. 20 Similar to the uveitis population, only patients who received the above diagnostic code by an ophthalmologist would be regarded as achieving the outcome.…”

Risk of Band Keratopathy in Patients with End-Stage Renal Disease

“…In this cohort study, we evaluated these comorbidities in ESRD patients and controls and found that iridocyclitis and phthisis bulbi are associated with higher incidences of band keratopathy in the ESRD patients compared with that in the controls ( Table 2 ) and are significant risk factors for band keratopathy in the cohort ( Table 3 ). Many reports demonstrated the link between iridocyclitis and band keratopathy 11 27 28 . They suggested that although the exact mechanism of calcium-phosphate precipitation in the superficial layers of cornea is unknown, it may result from deposition left as degeneration and necrosis from chronic inflammation related to iridocyclitis 11 27 28 .…”

“…Many reports demonstrated the link between iridocyclitis and band keratopathy 11 27 28 . They suggested that although the exact mechanism of calcium-phosphate precipitation in the superficial layers of cornea is unknown, it may result from deposition left as degeneration and necrosis from chronic inflammation related to iridocyclitis 11 27 28 . ESRD patients with iridocyclitis should be advised to control their inflammation through regular follow-up and treatment by ophthalmologists because of significant association with subsequent band keratopathy.…”