Bilateral Recurrent Calcareous Degeneration of the Cornea

Abstract

Keratoconjunctivitis sicca, epithelial defects, corneal inflammation, and infection are most probably responsible for the recurrent pancorneal calcification seen in our patient. The role of cytokines in this complication is discussed.

Late Onset Interface Calcium Deposition After Laser In Situ Keratomileusis

“…[14][15][16] In these settings, calcium deposition may occur because of an increase in the local concentration of calcium or phosphorus, an increase in pH, or an alteration in tear osmolality. 11,17,18 Because the individuals whom we report did not have a history of ocular surface inflammation, chronic use of topical ocular medications, ocular injury or surgery (other than LASIK), or elevated serum calcium levels, we believe that another condition likely led to an alteration in the corneal calcium or phosphorous level, the corneal pH, or the tear osmolarity, leading to a local increase in ionized calcium and subsequent deposition.…”

“…Although we are not able to determine the mechanism through which calcium deposited in the LASIK flap interface in the cases that we report, it is likely through one of the previously described mechanisms by which calcium deposits on the cornea. Superficial calcific corneal deposition has been associated with a variety of etiologies, including ocular surface inflammation, the use of various topical and intracameral medications, [6][7][8] ocular injury, 9 corneal, 10,11 or other ocular surgeries, 12,13 and systemic diseases affecting calcium metabolism. [14][15][16] In these settings, calcium deposition may occur because of an increase in the local concentration of calcium or phosphorus, an increase in pH, or an alteration in tear osmolality.…”

Late Onset Interface Calcium Deposition After Laser In Situ Keratomileusis

“…[14][15][16] In these settings, calcium deposition may occur because of an increase in the local concentration of calcium or phosphorus, an increase in pH, or an alteration in tear osmolality. 11,17,18 Because the individuals whom we report did not have a history of ocular surface inflammation, chronic use of topical ocular medications, ocular injury or surgery (other than LASIK), or elevated serum calcium levels, we believe that another condition likely led to an alteration in the corneal calcium or phosphorous level, the corneal pH, or the tear osmolarity, leading to a local increase in ionized calcium and subsequent deposition.…”

“…Although we are not able to determine the mechanism through which calcium deposited in the LASIK flap interface in the cases that we report, it is likely through one of the previously described mechanisms by which calcium deposits on the cornea. Superficial calcific corneal deposition has been associated with a variety of etiologies, including ocular surface inflammation, the use of various topical and intracameral medications, [6][7][8] ocular injury, 9 corneal, 10,11 or other ocular surgeries, 12,13 and systemic diseases affecting calcium metabolism. [14][15][16] In these settings, calcium deposition may occur because of an increase in the local concentration of calcium or phosphorus, an increase in pH, or an alteration in tear osmolality.…”

Rapid Corneal Calcification Following Endothelial Keratoplasty: A Case Report

“…Rapid calcification can extend deeply into the stroma, differing from band keratopathy [1,[5][6][7]. Continuous use of betamethasone sodium phosphate in the presence of an epithelial defect can cause rapid stromal calcification [2,8,9].…”

Management of Calcareous Corneal Degeneration from Medication Washout to Corneal Transplantation. Case Series and Review of the Literature

“…Corneal transplantation, either lamellar or full-thickness, represents the last option for deep calcareous deposition in eyes with severely impaired vision. However, a poor prognosis has been documented in these cases due to the high risk of recurrence of calcification, particularly in eyes with severe inflammation [1,3,11,18,21,23].…”

“…Although the typical slit lamp appearance of the corneal features makes easy clinical diagnosis, histopathologic examination remains the gold standard for definitive diagnosis, being able to offer a detailed microscopic analysis of the tissue. Despite the exact pathogenesis of the more profound form of calcium deposition not being fully understood, conservative and surgical treatment options have been proposed for its management [1][2][3][4][18][19][20][21][22][23].…”

Late Onset Interface Calcium Deposition After Laser In Situ Keratomileusis

“…[14][15][16] In these settings, calcium deposition may occur because of an increase in the local concentration of calcium or phosphorus, an increase in pH, or an alteration in tear osmolality. 11,17,18 Because the individuals whom we report did not have a history of ocular surface inflammation, chronic use of topical ocular medications, ocular injury or surgery (other than LASIK), or elevated serum calcium levels, we believe that another condition likely led to an alteration in the corneal calcium or phosphorous level, the corneal pH, or the tear osmolarity, leading to a local increase in ionized calcium and subsequent deposition.…”

“…Although we are not able to determine the mechanism through which calcium deposited in the LASIK flap interface in the cases that we report, it is likely through one of the previously described mechanisms by which calcium deposits on the cornea. Superficial calcific corneal deposition has been associated with a variety of etiologies, including ocular surface inflammation, the use of various topical and intracameral medications, [6][7][8] ocular injury, 9 corneal, 10,11 or other ocular surgeries, 12,13 and systemic diseases affecting calcium metabolism. [14][15][16] In these settings, calcium deposition may occur because of an increase in the local concentration of calcium or phosphorus, an increase in pH, or an alteration in tear osmolality.…”

Rapid Corneal Calcification Following Endothelial Keratoplasty: A Case Report

“…Rapid calcification can extend deeply into the stroma, differing from band keratopathy [1,[5][6][7]. Continuous use of betamethasone sodium phosphate in the presence of an epithelial defect can cause rapid stromal calcification [2,8,9].…”

Management of Calcareous Corneal Degeneration from Medication Washout to Corneal Transplantation. Case Series and Review of the Literature

“…Corneal transplantation, either lamellar or full-thickness, represents the last option for deep calcareous deposition in eyes with severely impaired vision. However, a poor prognosis has been documented in these cases due to the high risk of recurrence of calcification, particularly in eyes with severe inflammation [1,3,11,18,21,23].…”

“…Although the typical slit lamp appearance of the corneal features makes easy clinical diagnosis, histopathologic examination remains the gold standard for definitive diagnosis, being able to offer a detailed microscopic analysis of the tissue. Despite the exact pathogenesis of the more profound form of calcium deposition not being fully understood, conservative and surgical treatment options have been proposed for its management [1][2][3][4][18][19][20][21][22][23].…”

Late Onset Interface Calcium Deposition After Laser In Situ Keratomileusis

“…[14][15][16] In these settings, calcium deposition may occur because of an increase in the local concentration of calcium or phosphorus, an increase in pH, or an alteration in tear osmolality. 11,17,18 Because the individuals whom we report did not have a history of ocular surface inflammation, chronic use of topical ocular medications, ocular injury or surgery (other than LASIK), or elevated serum calcium levels, we believe that another condition likely led to an alteration in the corneal calcium or phosphorous level, the corneal pH, or the tear osmolarity, leading to a local increase in ionized calcium and subsequent deposition.…”

“…Although we are not able to determine the mechanism through which calcium deposited in the LASIK flap interface in the cases that we report, it is likely through one of the previously described mechanisms by which calcium deposits on the cornea. Superficial calcific corneal deposition has been associated with a variety of etiologies, including ocular surface inflammation, the use of various topical and intracameral medications, [6][7][8] ocular injury, 9 corneal, 10,11 or other ocular surgeries, 12,13 and systemic diseases affecting calcium metabolism. [14][15][16] In these settings, calcium deposition may occur because of an increase in the local concentration of calcium or phosphorus, an increase in pH, or an alteration in tear osmolality.…”

Rapid Corneal Calcification Following Endothelial Keratoplasty: A Case Report

“…Rapid calcification can extend deeply into the stroma, differing from band keratopathy [1,[5][6][7]. Continuous use of betamethasone sodium phosphate in the presence of an epithelial defect can cause rapid stromal calcification [2,8,9].…”

Management of Calcareous Corneal Degeneration from Medication Washout to Corneal Transplantation. Case Series and Review of the Literature

“…Corneal transplantation, either lamellar or full-thickness, represents the last option for deep calcareous deposition in eyes with severely impaired vision. However, a poor prognosis has been documented in these cases due to the high risk of recurrence of calcification, particularly in eyes with severe inflammation [1,3,11,18,21,23].…”

“…Although the typical slit lamp appearance of the corneal features makes easy clinical diagnosis, histopathologic examination remains the gold standard for definitive diagnosis, being able to offer a detailed microscopic analysis of the tissue. Despite the exact pathogenesis of the more profound form of calcium deposition not being fully understood, conservative and surgical treatment options have been proposed for its management [1][2][3][4][18][19][20][21][22][23].…”